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NPI Code Detail

MEDICARE: DR. WASYL WILLIAM FEDORIW MD

MEDICARE: DR. WASYL WILLIAM FEDORIW MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianP4162TX
2207X00000XOrthopaedic Surgery Physician125050811IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1125050811OTHERILILLINOIS STATE LICENSE NUMBER
2P4162OTHERTXTEXAS MEDICAL LICENSE

General Provider Information

NPI Number : 1063669471
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WASYL WILLIAM FEDORIW MD
Provider Business Mailing Address
First Line : PO BOX 207
Second Line :
City : HOUSTON
State : TX
Zip : 77001-0207
Country : US
Telephone Number : 713-650-6900
Fax Number : 888-355-5052
Provider Business Practice Location Address
First Line : 18885 KATY FWY
Second Line :
City : HOUSTON
State : TX
Zip : 77094-1103
Country : US
Telephone Number : 281-829-2000
Fax Number : 281-829-2220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2008
Last Update Date : 07/30/2025

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