Provider Demographics
NPI:1780833392
Name:PHILLIPS, KATHY (REEG/EP T, CNIM)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:REEG/EP T, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16131 N ELDRIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-9129
Mailing Address - Country:US
Mailing Address - Phone:281-970-5900
Mailing Address - Fax:281-970-5913
Practice Address - Street 1:16131 N ELDRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-9129
Practice Address - Country:US
Practice Address - Phone:281-970-5900
Practice Address - Fax:281-970-5913
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic