DR. BENNY POTHEN PHILLIPS (NPI# 1962497305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962497305 |
| Entity Type | Individual |
| Full Name | DR. BENNY POTHEN PHILLIPS |
| Credential | M.D. |
| Practice Address |
3621 22nd St Suite 100 Lubbock TX 79410-1301 |
| Practice Telephone | 8067961317 |
| Practice Fax Number | 8067960426 |
| Mailing Telephone | 8067961317 |
| Mailing Fax Number | 8067960426 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
F2851 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 84141N | 01 |
| Street Address |
3621 22ND ST SUITE 100 |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79410-1301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962404327 | Pulmonory Associates of Lubbock LLP | Internal Medicine | 3621 22nd St, Ste 400, Lubbock, TX 79410-1301 | 2005-08-15 |
| 1457965360 | Frances Greg Y Bordon | Nurse Practitioner | 3621 22nd St, Lubbock, TX 79410-1301 | 2020-09-08 |
| 1851842421 | Mandy Vanstory | Nurse Practitioner | 3621 22nd St, Suite 400, Lubbock, TX 79410-1301 | 2016-10-19 |
| 1417407149 | Michelle Amy Coffey | Nurse Practitioner | 3621 22nd St, Suite 400, Lubbock, TX 79410-1301 | 2016-10-05 |
| 1639579311 | Gynecologic Oncology Associates Pllc | Obstetrics & Gynecology | 3621 22nd St, Suite 100, Lubbock, TX 79410-1301 | 2014-08-29 |
| 1184068363 | Andrew Shakespeare | Internal Medicine | 3621 22nd St, Lubbock, TX 79410 | 2013-04-18 |
| 1407190705 | Brandi Nicole Maddigan | Nurse Practitioner | 3621 22nd St, Suite 400, Lubbock, TX 79410-1301 | 2012-11-27 |
| 1760657464 | Gloria Cleveland | Audiologist | 3621 22nd St, Lubbock, TX 79410-1301 | 2008-04-24 |
| 1912028622 | Brian Paul Williams | Internal Medicine | 3621 22nd St, Suite 400, Lubbock, TX 79410-1301 | 2007-04-02 |
| 1043259112 | Thomas F Neal | Otolaryngology | 3621 22nd St, Ste 300, Lubbock, TX 79410-1301 | 2006-06-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548878267 | Covenant Medical Center | Clinic/Center | 3615 19th, Lifestyle Centre-east Parking Garage, Lubbock, TX 79410 | 2020-07-20 |
| 1669038626 | Hub City Anesthesia | Nurse Anesthetist, Certified Registered | 3416 22nd Street, Lubbock, TX 79410 | 2019-05-15 |
| 1912447418 | Lubbock Surgery Center, LLC | Clinic/Center | 3416 22nd St, Lubbock, TX 79410 | 2017-03-02 |
| 1871032698 | Lezlee Berry | Pharmacist | 3615 19th Street, Lubbock, TX 79410 | 2017-02-13 |
| 1376914101 | Matthew Cotton | Nurse Practitioner | 2424 Quaker Ave, Lubbock, TX 79410 | 2015-10-20 |
| 1841534864 | Frank Nwabugwu | Pharmacist | 4120 34th Street, Lubbock, TX 79410 | 2012-11-15 |
| 1689954794 | Dharmendra Kumar | Pediatrics | Covenant Children's Hospital, 4000 24th Street, Lubbock, TX 79410 | 2011-08-19 |
| 1518277177 | T.r.m. Rao, M.d., P.a. | Colon & Rectal Surgery | 3809 22nd Street, Suite C, Lubbock, TX 79410 | 2010-10-18 |
| 1700196672 | Hanford Consultations P.a. | Family Medicine | 4000 22nd Place Suite 100, Lubbock, TX 79410 | 2010-10-13 |
| 1336452598 | Amanda Collins | Specialist | 4801 34th Street, Lubbock, TX 79410 | 2010-07-16 |
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| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659876 | Mark Brendan Reedy | Obstetrics & Gynecology | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2005-06-14 |
| 1073042859 | Women's Oncology, Pllc | Obstetrics & Gynecology | 3612 22nd Pl, Lubbock, TX 79410-1318 | 2017-06-06 |
| 1639579311 | Gynecologic Oncology Associates Pllc | Obstetrics & Gynecology | 3621 22nd St, Suite 100, Lubbock, TX 79410-1301 | 2014-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235779299 | Beverly Gail Hutzler | Obstetrics & Gynecology | 4502 Medical Dr # 71-1, San Antonio, TX 78229-4402 | 2020-01-07 |
| 1548827496 | Jeffrey Andrew How | Obstetrics & Gynecology | 1155 Herman Pressler, Unit 1362, Houston, TX 77030-4000 | 2019-05-28 |
| 1790123156 | Hatem Hatem | Obstetrics & Gynecology | 7719 S Ih 35 Ste 220, San Antonio, TX 78224-1469 | 2013-06-07 |
| 1619286465 | Behrouz Zand | Obstetrics & Gynecology | 18100 St. John Dr., Suite 250, Nassau Bay, TX 77058 | 2010-09-28 |
| 1033435367 | Abel Moron | Obstetrics & Gynecology | 12200 Park Central Dr Ste 410, Dallas, TX 75251-2101 | 2010-04-12 |
| 1043295728 | Christine M. Lee | Obstetrics & Gynecology | 920 Medical Plaza Dr Ste 300, Shenandoah, TX 77380-3256 | 2005-12-14 |
| 1467435982 | Carlos Alberto Herrera | Obstetrics & Gynecology | 2717 Michael Angelo, Ste 304, Edinburg, TX 78539 | 2005-11-29 |
| 1447232467 | John L. Dalrymple | Obstetrics & Gynecology | 911 W 38th St, Suite 202, Austin, TX 78705-1188 | 2005-11-16 |
| 1184615452 | Edward Robert Kost | Obstetrics & Gynecology | 903 W Martin St, San Antonio, TX 78207-0903 | 2005-11-04 |
| 1376017715 | Oncology Specialists of Texas, Pllc | Obstetrics & Gynecology | 17350 St Lukes Way Ste 350, The Woodlands, TX 77384-4103 | 2019-01-18 |
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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.