MEDICARE: NANCY G FAIGIN DO

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	E4837	TX

General Provider Information

NPI Number	:	1245262484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY G FAIGIN DO

Provider Business Mailing Address
First Line	:	5703 WEST CREEK DR
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76133-3395
Country	:	US
Telephone Number	:	817-294-0731
Fax Number	:	817-294-8065

Provider Business Practice Location Address
First Line	:	5703 WEST CREEK DR
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76133-3395
Country	:	US
Telephone Number	:	817-294-0731
Fax Number	:	817-294-8065

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	02/17/2010

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