MEDICARE: DR. JIANWEI FENG 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
1	207RC0000X	Cardiovascular Disease Physician	L6884	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	8S5030	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1417972688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIANWEI FENG MD

Provider Business Mailing Address
First Line	:	6609 W SAM HOUSTON PKWY S
Second Line	:	STE 102
City	:	HOUSTON
State	:	TX
Zip	:	77072-1641
Country	:	US
Telephone Number	:	713-595-9000
Fax Number	:	713-595-8500

Provider Business Practice Location Address
First Line	:	6609 W SAM HOUSTON PKWY S STE 102
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-1641
Country	:	US
Telephone Number	:	713-595-9000
Fax Number	:	713-595-8500

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/01/2021

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