Provider Demographics
NPI:1649393463
Name:PHILLIPS, DIANE SCHLUP (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:SCHLUP
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8201 PRESTON RD
Mailing Address - Street 2:SUITE 560
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6203
Mailing Address - Country:US
Mailing Address - Phone:214-360-0108
Mailing Address - Fax:214-360-0442
Practice Address - Street 1:8201 PRESTON RD
Practice Address - Street 2:SUITE 560
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6203
Practice Address - Country:US
Practice Address - Phone:214-360-0108
Practice Address - Fax:214-360-0442
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2686207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC20490Medicare UPIN