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General NPI Number Information
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NPI Number | 1770587016
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Entity Type | Individual
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Provider Name | XIAO-EN FANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 700 HIGHLANDER BLVD STE 415
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City | ARLINGTON
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State | TX
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Zip | 76015-4346
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Country | US
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Telephone | 817-516-8811
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Fax | 817-516-8444
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Provider Business Mailing Address
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Address Line | PO BOX 731475
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City | DALLAS
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State | TX
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Zip | 75373-1475
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Country | US
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Telephone | 817-516-8811
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Fax | 817-516-8444
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | J0823
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | J0823
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | J0823
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License Number State | TX
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