1649229790 NPI number — BRIAN ARTHUR FEAGINS M.D.

Table of content: BRIAN ARTHUR FEAGINS M.D. (NPI 1649229790)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649229790 NPI number — BRIAN ARTHUR FEAGINS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEAGINS
Provider First Name:
BRIAN
Provider Middle Name:
ARTHUR
Provider Name Prefix Text:
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:
1649229790
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 GASTON AVE
Provider Second Line Business Mailing Address:
STE 1205
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75246-1800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-692-8262
Provider Business Mailing Address Fax Number:
214-696-4190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10501 N. CENTRAL EXPRESSWAY
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75231-2200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-360-1535
Provider Business Practice Location Address Fax Number:
214-360-1534
Provider Enumeration Date:
05/08/2006

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: 208800000X , with the licence number:  H5440 , 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: 80407X . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00194243 . This is a "MEDICARE RR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".