MEDICARE: DR. FRANK FEIGENBAUM M. D.

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
1	174400000X	Specialist	2000155782	MO
2	174400000X	Specialist	04-28677	KS
3	174400000X	Specialist	P1751	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215909593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK FEIGENBAUM M. D.

Provider Business Mailing Address
First Line	:	4925 GREENVILLE AVE STE 1307
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-4026
Country	:	US
Telephone Number	:	214-242-1389
Fax Number	:	214-351-8451

Provider Business Practice Location Address
First Line	:	4925 GREENVILLE AVE STE 1307
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-4026
Country	:	US
Telephone Number	:	214-242-1389
Fax Number	:	214-351-8451

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2006
Last Update Date	:	05/04/2022

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Directions to “ DR. FRANK FEIGENBAUM M. D.” Practice Location

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