Healthcare Provider Details

I. General information

NPI: 1093757254
Provider Name (Legal Business Name): AL EDWARD FAIGIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5703 WESTCREEK
FORT WORTH TX
76133
US

IV. Provider business mailing address

5703 WESTCREEK
FORT WORTH TX
76133
US

V. Phone/Fax

Practice location:
  • Phone: 817-294-0731
  • Fax: 817-294-8065
Mailing address:
  • Phone: 817-294-0731
  • Fax: 817-294-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE4836
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: