Provider Demographics
NPI:1487634366
Name:VOLS, PHYLLIS A (RSA RST)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:A
Last Name:VOLS
Suffix:
Gender:F
Credentials:RSA RST
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:A
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RSA RST
Mailing Address - Street 1:7324 SOUTHWEST FWY STE 1550
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7324 SOUTHWEST FWY STE 1550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-779-9800
Practice Address - Fax:713-988-8402
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238000045174400000X
246ZC0007X
IL237000011246ZS0410X
IL238.000045363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No174400000XOther Service ProvidersSpecialist
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist