MR. DERALD PHILLIPS PA NPI 1972083137

NPI Information

MR. Derald Phillips, PA is a medical physician assistant in Amarillo, TX with 6 years of experience. MR. Derald Phillips, PA NPI is 1972083137. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2018

The provider's business location address is:

1901 MEDI PARK DR STE 2050
AMARILLO, TX
ZIP 79106-109
Phone: (806) 355-3352

The NPI 1972083137 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/17/2018 and was last updated on 5/15/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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