RANDALL R PHILLIPS (NPI# 1295763183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295763183 |
| Entity Type | Individual |
| Full Name | RANDALL R PHILLIPS |
| Credential | DO |
| Practice Address |
855 Montgomery St Fort Worth TX 76107-2553 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8177355450 |
| Practice Fax Number | 8177355454 |
| Mailing Telephone | 8177355450 |
| Mailing Fax Number | 8177355454 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2009-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
H6916 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | RAILROAD MEDICARE PIN | 240004825 | 01 |
| TX | 114589804 | 05 | |
| TX | BCBS | 846875 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104083997 | Randall Jerald Phillips | Dentist | 516 Candler St, Gainesville, GA 30501-3332 | 2008-05-20 |
| 1154304962 | Randall Phillips | Radiology | 2780 Middle Country Rd Ste 210, Lake Grove, NY 11755-2120 | 2005-11-25 |
| 1851662860 | Randall Austin Phillips Jr. | Social Worker | 301 Nw 63rd St, Suite 301, Oklahoma City, OK 73116-7907 | 2012-01-23 |
| 1841248705 | Randall Phillips | Physical Therapist | 96 Macon Center Dr, Franklin, NC 28734-6779 | 2006-05-04 |
| 1124099395 | Randall Joseph Phillips | Radiology | 5001 Us Highway 30 W Ste D, Fort Wayne, IN 46818-9701 | 2006-01-27 |
| 1306848940 | Randall Wallace Phillips | Marriage & Family Therapist | 367b N Parkway, Jackson, TN 38305-2865 | 2005-08-12 |
| Street Address |
855 MONTGOMERY ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194455 | Patricia Lowrimore | Psychiatry & Neurology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2005-06-20 |
| 1194353417 | Jason L Thompson | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-03-31 |
| 1639701808 | Tyrane Roberts-lagrone | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-02-06 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1629553813 | Lisa Jane Killam-worrall | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-10-03 |
| 1598250607 | Sima Taj Mozdbar | Optometrist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-06-30 |
| 1588153993 | Kristen Reuter | Social Worker | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-05-02 |
| 1114431624 | Emily J. Clark | Counselor | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-11-20 |
| 1275073215 | Elizabeth Svyatoslavna Balyakina | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-23 |
| 1588103659 | Frederick Olen Barnum Iv | Family Medicine | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 207YS0123X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Facial Plastic Surgery |
| An otolaryngologist who specializes in facial plastic surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate was, but is no longer issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811164296 | Advanced Cosmetic Surgery Ctr Wm K Miles Md Pa | Otolaryngology | 800 8th Avenue, Suite 404, Fort Worth, TX 76104-2618 | 2008-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033624663 | Texas Center for Facial Plastic & Laser Surgery, LLC | Otolaryngology | 14603 Huebner Rd Ste 102, San Antonio, TX 78230-5469 | 2017-12-05 |
| 1558872952 | C. Guy Fps, Pllc | Otolaryngology | 1129 Aberdeen Rd, Waco, TX 76712 | 2017-10-12 |
| 1124545660 | Cilento Facial Plastic Surgery Pllc | Otolaryngology | 63 Olmstead Row, The Woodlands, TX 77380-2874 | 2017-08-25 |
| 1154717445 | W. Marshall Guy, Md Pllc | Otolaryngology | 128 Vision Park Blvd Ste 150, Shenandoah, TX 77384-3021 | 2015-04-13 |
| 1033414115 | Philip Yosowitz, M.d., P.a. | Otolaryngology | 75515 S. Main, #730, Houston, TX 77030 | 2011-01-20 |
| 1366769937 | Texas Facial Plastic Surgery and Rhinology | Otolaryngology | 503 Medical Center Blvd Ste 120, Conroe, TX 77304-2936 | 2010-04-22 |
| 1659520906 | Robert William Brobst Jr. | Otolaryngology | 4800 Hedgcoxe Rd # 250, Plano, TX 75024-2403 | 2008-09-11 |
| 1336346535 | Charles Walker Guy II | Otolaryngology | 101 Burnett Ct Ste B, Waco, TX 76712-3100 | 2007-06-29 |
| 1003941790 | Hector Martinez Viera | Otolaryngology | 2530 W Holcombe Blvd, Houston, TX 77030-1904 | 2007-02-22 |
| 1194889642 | Russell William Kridel | Otolaryngology | 6655 Travis St Ste 900, Houston, TX 77030-1336 | 2006-12-20 |
| Find all providers with the same taxonomy | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.