1447219340 NPI number — DR. DAVID M FERNEY M.D.

Table of content: DR. DAVID M FERNEY M.D. (NPI 1447219340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447219340 NPI number — DR. DAVID M FERNEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNEY
Provider First Name:
DAVID
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447219340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7610 N STEMMONS FWY
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75247-4231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-689-5960
Provider Business Mailing Address Fax Number:
469-713-8084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 CENTRAL DR
Provider Second Line Business Practice Location Address:
SUITE 155
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76022-6000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-267-8470
Provider Business Practice Location Address Fax Number:
817-267-0396
Provider Enumeration Date:
03/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  G6830 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 123436103 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 84Y112 . This is a "BCBSTX" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com