Healthcare Provider Details

I. General information

NPI: 1801699947
Provider Name (Legal Business Name): NADEZHDA A FELDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ALLIED DR
PLANO TX
75093-5348
US

IV. Provider business mailing address

802 CINNABAR WAY
PRINCETON TX
75407-3248
US

V. Phone/Fax

Practice location:
  • Phone: 469-814-4280
  • Fax:
Mailing address:
  • Phone: 903-268-4833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number196079
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: