MEDICARE: DR. JOSEPH L FELDHAUS D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	J3791	TX

General Provider Information

NPI Number	:	1033103726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH L FELDHAUS D.O.

Provider Business Mailing Address
First Line	:	PO BOX 967
Second Line	:
City	:	EDEN
State	:	TX
Zip	:	76837-0967
Country	:	US
Telephone Number	:	325-869-6171
Fax Number	:	325-869-8118

Provider Business Practice Location Address
First Line	:	506 EAKER
Second Line	:
City	:	EDEN
State	:	TX
Zip	:	76837-0967
Country	:	US
Telephone Number	:	325-869-6171
Fax Number	:	325-869-8118

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	01/11/2008

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