1407923337 NPI number — MRS. SUNILA PHILIPS MD

Table of content: MRS. SUNILA PHILIPS MD (NPI 1407923337)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407923337 NPI number — MRS. SUNILA PHILIPS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PHILIPS
Provider First Name:
SUNILA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABRAHAM
Provider Other First Name:
SUNILA
Provider Other Middle Name:
P
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407923337
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3120 HUDSON XING STE B2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75070-6555
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-476-2000
Provider Business Mailing Address Fax Number:
469-476-2001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3120 HUDSON CROSSING
Provider Second Line Business Practice Location Address:
SUITE # B2
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75070-6555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-726-2000
Provider Business Practice Location Address Fax Number:
469-476-2001
Provider Enumeration Date:
11/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  233497 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QG0300X , with the licence number: 233497 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QG0300X , with the licence number: N9113 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: N9113 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: L0180905 . This is a "DPS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 02618422 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".