Provider Demographics
NPI:1437466547
Name:NIKITA R. PHILLIPS
Entity Type:Organization
Organization Name:NIKITA R. PHILLIPS
Other - Org Name:J AND N FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIKITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-255-1109
Mailing Address - Street 1:7322 SOUTHWEST FWY
Mailing Address - Street 2:STE. 640
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2010
Mailing Address - Country:US
Mailing Address - Phone:713-255-1109
Mailing Address - Fax:713-255-1108
Practice Address - Street 1:7322 SOUTHWEST FWY
Practice Address - Street 2:STE. 640
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2010
Practice Address - Country:US
Practice Address - Phone:713-255-1109
Practice Address - Fax:713-255-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty