MEDICARE: OREN N FASS 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	207W00000X	Ophthalmology Physician	N0758	TX
2	207WX0120X	Cornea and External Diseases Specialist Physician	N0758	TX
3	174400000X	Specialist	N0758	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
15	P00222036	OTHER	GA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	257628	OTHER	GA	COVENTRY HMO
2	513957	OTHER	GA	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	10061047	OTHER	GA	AMERIGROUP
7	3704635	OTHER	GA	AETNA HMO
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	906070	OTHER	GA	COVENTRY PPO
10	373517	OTHER	GA	BCBS
11	951740	OTHER	GA	BCBS
12	7325471	OTHER	GA	AETNA
13	0800646	OTHER	GA	UHC
14	294525	OTHER	GA	WELLCARE

General Provider Information

NPI Number	:	1417954819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OREN N FASS M.D.

Provider Business Mailing Address
First Line	:	2301 S HAMPTON RD STE 500
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75224-1654
Country	:	US
Telephone Number	:	214-330-3937
Fax Number	:	214-330-3939

Provider Business Practice Location Address
First Line	:	2301 S HAMPTON RD STE 500
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75224-1654
Country	:	US
Telephone Number	:	214-330-3937
Fax Number	:	214-330-3939

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	06/18/2021

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2301 S HAMPTON RD STE 800
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Directions to “ OREN N FASS M.D.” Practice Location

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