Provider Demographics
NPI:1548872807
Name:PHILIP, STEPHEN (RPH)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:PHILIP
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 SUMMER BAY DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4453
Mailing Address - Country:US
Mailing Address - Phone:281-871-9850
Mailing Address - Fax:
Practice Address - Street 1:13555 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6056
Practice Address - Country:US
Practice Address - Phone:281-776-3858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65425183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist