Provider Demographics
NPI:1992795553
Name:PHILLIPS, DANA SPEER (MD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:SPEER
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST # MS 8340
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-2340
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST FL 3
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2340
Practice Address - Fax:806-743-1775
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4720207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM52442OtherPRESBYTERIAN COMMERCIAL
TX128302003Medicaid
NM52442Medicaid
TX121443100OtherFRISTCARE COMMERCIAL
TX83G031OtherBC/BS
TX80834ZOtherHMO BLUE
OK100141790AMedicaid
TX121443102Medicaid
NMA249OtherTRIWEST
TX128302002Medicaid
NML5451Medicaid