IndividualActive
Wallace Phillips, O.D.
NPI 1457444580 · Optometrist · Kermit, TX
Provider details
- NPI number
- 1457444580
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2869TG (TX)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
103 S East Ave
Kermit, TX 79745-3606
Phone: (432) 586-3435
Fax: (432) 586-6737
Approximate (ZIP-level) locationGet directions
Mailing address
103 S East Ave
Kermit, TX 79745-3606
Registry dates
- Enumerated
- 2006-10-02
- Last updated
- 2010-07-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.