JACK E. PHILLIPS


Address: 6101 Gateway Blvd. West, El Paso, TN 79912-3416
Phone: 9157750424

JACK E. PHILLIPS (NPI# 1649273020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649273020
Entity Type Individual
Full Name JACK E. PHILLIPS
Other Name JACK E. PHILLIPS
Credential O.D.
Practice Address 6101 Gateway Blvd. West
El Paso
TN 79912-3416
Mailing Address 6225 Camino Alegre Dr.
El Paso
TN 79912-2611
Practice Telephone 9157750424
Practice Fax Number 9157752429
Mailing Telephone 9155813636
Mailing Fax Number 9158454412
Enumeration Date 2005-05-31
Last Update Date 2007-07-08
NPI Deactivation Date 03/17/2006
NPI Reactivation Date 2006-03-28
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 152WC0802X Optometrist
Specialization: Corneal and Contact Management
4910T TX Eye and Vision Services Providers

Other Providers JACK PHILLIPS

NPI Name Taxonomy Address Enumeration
1407100902 Jack Austin Phillips Adult Companion 5023 Ne Killingsworth St, Portland, OR 97218-1915 2012-11-05
1861603722 Jack Howard Phillips Counselor Psychiatry, Madigan Army Medical Center, Tacoma, WA 98431-0001 2007-05-24

Office Location

Street Address 6101 GATEWAY BLVD. WEST
City EL PASO
State TN
Zip Code 79912-3416

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1760030290 Susan De La Cruz Nurse Practitioner 6600 N Dessert Blvd, El Paso, TX 79912 2019-08-28
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1831669423 Jorge Lorenzo Soto Occupational Therapy Assistant 4700 N. Mesa St. F-4, El Paso, TX 79912 2018-11-27
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1679078927 Kassandra Ashley Wright Registered Nurse 330 Bartlett Dr. Apt 2002, El Paso, TX 79912 2018-03-28
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Taxonomy Information

Taxonomy Code 152WC0802X
Grouping Eye and Vision Services Providers
Classification Optometrist
Specialization Corneal and Contact Management

Taxonomy Definition

The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear.
Notes: Source: American Optometric Association [1/1/2009: added definition, added source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1437261690 Morris David Reiter Optometrist 750 Sunland Park Dr, Sunland Park Mall - Space D6, El Paso, TX 79912-6709 2006-08-31
1760444293 Mario A Caballero Optometrist 10952 Ben Crenshaw Dr, Suite A, El Paso, TX 79935-3043 2006-04-03
1114919701 Louis Martin Mcmahon Optometrist 9513 Viscount Blvd, Suite B, El Paso, TX 79925-7025 2005-08-18
1336612613 Demarco Eyecare Associates Pllc Optometrist 7555 N Mesa St, El Paso, TX 79912-3505 2019-01-09
1043739568 James Joseph Demarco Jr. Optometrist 7555 N Mesa St, El Paso, TX 79912-3505 2017-09-15
1104359751 Apex Eyecare Pllc Optometrist 8080 Gateway Blvd E, El Paso, TX 79907-1275 2017-04-10
1215254966 Buena Vista Eye Care Pllc Optometrist 1300 Murchison Dr, Suite 140, El Paso, TX 79902-4842 2010-04-20
1427281435 Richard Nevins Optometrist 1850 N Zaragoza Rd, El Paso, TX 79936-7911 2009-08-25
1114178316 Mario A. Caballero Od PC Optometrist 10952 Ben Crenshaw Dr, El Paso, TX 79935-3043 2008-10-06
1972761856 Eye World Optometrist 9513 Viscount Blvd, Suite B, El Paso, TX 79925-7025 2008-05-28
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Competitor

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City EL PASO
Zip Code 79912

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Dataset Information

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.

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