Provider Demographics
NPI:1801158183
Name:PHILLIPS, PATRICK T (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:T
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 731263
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1263
Mailing Address - Country:US
Mailing Address - Phone:469-204-2021
Mailing Address - Fax:469-204-2036
Practice Address - Street 1:1500 S DALLAS PKWY
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-3495
Practice Address - Country:US
Practice Address - Phone:469-204-2021
Practice Address - Fax:469-204-2036
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA139283207R00000X
TXR7087207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine