MEDICARE: FRANK TERRELL FELTS 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	G5037	TX
2	208600000X	Surgery Physician	MD2006-0484	NM

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

General Provider Information

NPI Number	:	1366406639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK TERRELL FELTS M.D.

Provider Business Mailing Address
First Line	:	2100 S TRIVIZ DR
Second Line	:	STE G
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-0601
Country	:	US
Telephone Number	:	575-556-1849
Fax Number	:	575-532-2030

Provider Business Practice Location Address
First Line	:	2100 S TRIVIZ DR
Second Line	:	SUITE G
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-0605
Country	:	US
Telephone Number	:	575-556-1849
Fax Number	:	575-532-2030

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	01/30/2018

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