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NPI Code Detail

MEDICARE: DR. RAWLE FABIAN PHILBERT DDS

MEDICARE: DR. RAWLE FABIAN PHILBERT DDS
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
1122300000XDentist37107TX
2204E00000XOral & Maxillofacial Surgery (D.M.D.)37107TX
31223S0112XOral and Maxillofacial Surgery (Dentist)042847NY

General Provider Information

NPI Number : 1275619124
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAWLE FABIAN PHILBERT DDS
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-5347
Country : US
Telephone Number : 214-645-0600
Fax Number : 214-645-2762
Provider Business Practice Location Address
First Line : 6201 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-5202
Country : US
Telephone Number : 214-648-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 08/05/2024

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