Provider Demographics
NPI:1851988711
Name:PHILLIPS, ELISHA (NRCCS)
Entity Type:Individual
Prefix:MRS
First Name:ELISHA
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:NRCCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9999 W MONTGOMERY RD STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-3100
Mailing Address - Country:US
Mailing Address - Phone:832-233-1916
Mailing Address - Fax:
Practice Address - Street 1:9999 W MONTGOMERY RD STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-3100
Practice Address - Country:US
Practice Address - Phone:832-835-8220
Practice Address - Fax:832-553-7206
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health