Provider Demographics
NPI:1508981903
Name:PHILLIPS, CATHERINE LEBOURDAIS (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LEBOURDAIS
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ALMA DR STE 135
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-8807
Mailing Address - Country:US
Mailing Address - Phone:972-424-5840
Mailing Address - Fax:
Practice Address - Street 1:700 ALMA DR STE 135
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-8807
Practice Address - Country:US
Practice Address - Phone:972-424-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G3836Medicare ID - Type UnspecifiedPHYSICAL THERAPY