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General NPI Number Information
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NPI Number | 1538113469
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Entity Type | Individual
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Provider Name | HERBERT A. PHELAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD E5-508
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City | DALLAS
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State | TX
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Zip | 75390-9158
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Country | US
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Telephone | 214-648-6841
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Fax | 214-648-5477
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-5347
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Country | US
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Telephone | 214-648-6841
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Fax | 214-648-5477
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 26277
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 26277
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | L6574
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License Number State | TX
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