Ralidis, Philip Mark

Ralidis, Philip Mark is an individual health care provider with primary practice located at 601 E 15Th St , Austin TX 78701-1930. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Ralidis, Philip Mark can be contacted via phone (512) 324-7000.

Contact Information

Primary practice address
601 E 15Th St Austin TX 78701-1930
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X J7147 Texas

Profile Details

NPI number 1487619128
LBN Legal business name Ralidis, Philip Mark
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487619128 NPPES
Texas MEDICAID 123643205

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