Provider Demographics
NPI:1205646270
Name:FELTON, PHILIP JOSEPH (LAT)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:JOSEPH
Last Name:FELTON
Suffix:
Gender:M
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 MEADOWGREEN LN
Mailing Address - Street 2:
Mailing Address - City:NEEDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77461-8781
Mailing Address - Country:US
Mailing Address - Phone:713-582-0391
Mailing Address - Fax:
Practice Address - Street 1:7215 MEADOWGREEN LN
Practice Address - Street 2:
Practice Address - City:NEEDVILLE
Practice Address - State:TX
Practice Address - Zip Code:77461-8781
Practice Address - Country:US
Practice Address - Phone:713-582-0391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT07432081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine