Healthcare Provider Details

I. General information

NPI: 1740228717
Provider Name (Legal Business Name): STEVEN H FEHRENKAMP MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 JAMES CASEY A230
AUSTIN TX
78745
US

IV. Provider business mailing address

4007 JAMES CASEY A230
AUSTIN TX
78745
US

V. Phone/Fax

Practice location:
  • Phone: 512-445-2833
  • Fax: 512-445-4121
Mailing address:
  • Phone: 512-445-2833
  • Fax: 512-445-4121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE8463
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberE8463
License Number StateTX

VIII. Authorized Official

Name: STEVEN HARRY FEHRENKAMP
Title or Position: OWNER
Credential: MD
Phone: 512-445-2833