PAUL PHILLIPS (NPI# 1306293881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306293881 |
| Entity Type | Individual |
| Full Name | PAUL PHILLIPS |
| Credential | LCDC |
| Practice Address |
104 Jordan Plaza Blvd Ste 402-403 Tyler TX 75704-2055 |
| Practice Telephone | 9035819472 |
| Mailing Telephone | 9035819472 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
11128 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TEXAS STATE LICENSE LCDC | 11128 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215290580 | Paul Phillips Iv | Orthopaedic Surgery | 478 S Johnson St Fl 6, New Orleans, LA 70112-2238 | 2012-06-20 |
| 1750531398 | Paul Williams Phillips Jr. | Orthopaedic Surgery | 1524 Us Hwy 395 Ste 2, Gardnerville, NV 89410 | 2008-09-19 |
| 1134381965 | Paul M Phillips | Surgery | 651 S Mesa Hills Dr, El Paso, TX 79912-5540 | 2008-07-02 |
| 1356440168 | Paul Stanley Phillips | Dentist | 1005 39th St, Sacramento, CA 95816-5502 | 2006-09-21 |
| 1073538153 | Paul S Phillips | Ophthalmology | 6b Minneakoning Rd Ste 304, Flemington, NJ 08822-5799 | 2006-07-12 |
| 1194792051 | Paul Jeffrey Phillips | Dentist | 400 Laboratory Rd, Suite 101, Oak Ridge, TN 37830-6810 | 2006-02-28 |
| 1427051937 | Paul Kenneth Phillips | Psychiatry & Neurology | 1940 Harrison Ave, Panama City, FL 32405-4542 | 2005-05-30 |
| 1467990663 | Paul Phillips | Technician, Other | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-02-08 |
| 1841632767 | Paul Matthew Phillips | Social Worker | 10819 Rockaway Blvd, South Ozone Park, NY 11420-1034 | 2013-07-19 |
| 1619244647 | Paul Bernard Phillips | Chiropractor | 914 W Carlisle Ave, Spokane, WA 99205-3309 | 2011-11-18 |
| Street Address |
104 JORDAN PLAZA BLVD STE 402-403 |
| City | TYLER |
| State | TX |
| Zip Code | 75704-2055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386198901 | Lee Ann Decker | Counselor | 104 Jordan Plaza Blvd Ste 402-403, Tyler, TX 75704-2055 | 2016-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194325415 | Rupal R Patel | Pharmacist | 3820 Tx 64, Tyler, TX 75704 | 2020-10-27 |
| 1932757945 | Gracelyn Hernandez Kuester | Technician | 14320 Country Road 420, Tyler, TX 75704 | 2019-09-03 |
| 1033770227 | Rajamanoj Kondaveeti | Dentist | 3873 Tx-64, Tyler, TX 75704 | 2019-06-27 |
| 1063070209 | Susan Michele Whitaker | Counselor | The Beginning, 114 Jordan Plaza Blvd Suite 302, Tyler, TX 75704 | 2019-06-03 |
| 1649836768 | Tyla Sherrie' Tarrant | Licensed Vocational Nurse | 3050 Cr 427, #502, Tyler, TX 75704 | 2019-05-14 |
| 1437458874 | North Mesa Dental, PC | Dentist | 3864 Hwy 64 West, Tyler, TX 75704 | 2011-03-24 |
| 1093025751 | Zana Elliot Enterprises LLC | Nurse Practitioner | 12751 Westbrook Dr, Tyler, TX 75704 | 2010-10-15 |
| 1710036454 | Tammy Jimenez | Dietitian, Registered | 5555 W. Twin Lakes Dr., Tyler, TX 75704 | 2007-01-10 |
| 1063023935 | Shanika Lanell Grant | Licensed Vocational Nurse | 134 Patton Ln, Tyler, TX 75704-2004 | 2020-08-13 |
| 1194342410 | Shanequia Dianne Flowers | Licensed Vocational Nurse | 404 Lemay Dr, Tyler, TX 75704-2031 | 2020-07-02 |
| Find all providers in zip 75704 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124642798 | Erin Cameron | Counselor | 120 W 5th St Ste 105, Tyler, TX 75701-4053 | 2020-05-29 |
| 1376162354 | Noel M Slagle | Counselor | 114 Jordan Plaza Blvd, Tyler, TX 75704-2056 | 2020-04-10 |
| 1982256665 | Amy Lynn Chapmond | Counselor | 114 Jordan Plaza Blvd Ste 302306, Tyler, TX 75704-2056 | 2019-07-12 |
| 1063070209 | Susan Michele Whitaker | Counselor | The Beginning, 114 Jordan Plaza Blvd Suite 302, Tyler, TX 75704 | 2019-06-03 |
| 1477111995 | Alma Bluesummers | Counselor | 114 Jordan Plaza Blvd Ste 302, Tyler, TX 75704-2056 | 2019-05-30 |
| 1669937041 | Bonnie Ann Blattman Beaulieu | Counselor | 3400 Nne Loop 323 Trlr 34, Tyler, TX 75708-5607 | 2019-02-09 |
| 1821577628 | Jahn Quattlebaum | Counselor | 6200 Wilshire Dr, Tyler, TX 75703-4159 | 2018-08-13 |
| 1831684349 | Andrew Bednarek | Counselor | 1510 S. Vine Street, Tyler, TX 75771 | 2018-06-27 |
| 1811482581 | Robert M Parnell | Counselor | 1510 S Vine Ave, Tyler, TX 75701-2826 | 2018-06-26 |
| 1902309487 | Tina Renae Huseth | Counselor | 11849 County Road 461, Tyler, TX 75706-4823 | 2018-03-12 |
| Find all providers in TYLER | ||||
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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.