Provider Demographics
NPI:1912387085
Name:CAUSEY, PHILLIP JR (MS OTR, CEAS, II)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:CAUSEY
Suffix:JR
Gender:M
Credentials:MS OTR, CEAS, II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20811 ATASCOCITA SHORES DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1621
Mailing Address - Country:US
Mailing Address - Phone:936-635-4802
Mailing Address - Fax:
Practice Address - Street 1:20811 ATASCOCITA SHORES DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1621
Practice Address - Country:US
Practice Address - Phone:936-635-4802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111107174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist