Wallace L Phillips, OD is a medicare enrolled "Optometrist" provider in Kermit, Texas. His current practice location is
103 S East Ave, Kermit, Texas. You can reach out to his office (for appointments etc.) via phone at
(432) 586-3435.
Wallace L Phillips is licensed to practice in Texas (license number 2869TG) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1457444580.
Healthcare Provider's Profile
| Full Name | Wallace L Phillips |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 103 S East Ave, Kermit, Texas |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Wallace L Phillips attended and graduated from in
NPI Data:
- NPI Number: 1457444580
- Provider Enumeration Date: 10/02/2006
- Last Update Date: 07/06/2010
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Wallace L Phillips such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457444580 | NPI | - | NPPES |
| 00E80D | Other | | BLUE CROSS/BLUE SHIELD |
| 032932801 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 2869TG (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wallace L Phillips is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Wallace L Phillips, OD
103 S East Ave,
Kermit, TX 79745-3606
Ph: (432) 586-3435 | Wallace L Phillips, OD
103 S East Ave,
Kermit, TX 79745-3606
Ph: (432) 586-3435 |
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