Provider Demographics
NPI:1700883519
Name:PHIPPS, WENDY D (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:D
Last Name:PHIPPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:401 BOSTON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2601
Mailing Address - Country:US
Mailing Address - Phone:915-544-9700
Mailing Address - Fax:915-544-9701
Practice Address - Street 1:125 W HAGUE RD
Practice Address - Street 2:SUITE 360
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5814
Practice Address - Country:US
Practice Address - Phone:915-544-9700
Practice Address - Fax:915-544-9701
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2013-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL4648207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165329703Medicaid
TX165329703Medicaid
TX8C0538Medicare PIN
TX165329703Medicaid