Philip Phan
Behavior Technician in Round Rock, TX. Individual provider (NPI-1).
NPI number1659032142
StatusActive
Last updated in NPPESJan 6, 2022
Details
- NPI
- 1659032142
- Entity type
- Individual (NPI-1)
- Name
- Philip Phan
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 6, 2022
- Certification date
- Jan 6, 2022
- Last updated
- Jan 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
170 Deep Wood Dr Ste 104Round Rock, TX 78681-4949
Phone 512-910-3251
Mailing address
170 Deep Wood Dr Ste 104Round Rock, TX 78681-4949
Phone 512-910-3251
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