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General NPI Number Information
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NPI Number | 1851439780
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Entity Type | Organization
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Legal Business Name | JEFFREY A FEARON MD P A
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 7777 FOREST LN STE C700
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City | DALLAS
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State | TX
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Zip | 75230-2518
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Country | US
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Telephone | 972-566-6464
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Fax | 972-566-6279
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN STE C700
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City | DALLAS
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State | TX
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Zip | 75230-2518
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Country | US
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Telephone | 972-566-6464
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Fax | 972-566-6279
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | ALONDRA E TIPPS
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Credential | MBA CFO CMOM
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Telephone | 972-566-6464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | H8638
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License Number State | TX
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