MEDICARE: MRS. PATRICIA SUE FELTRUP-EXUM LMFT

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	106H00000X	Marriage & Family Therapist	4806	TX

General Provider Information

NPI Number	:	1619926219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA SUE FELTRUP-EXUM LMFT

Provider Business Mailing Address
First Line	:	6551 HARRIS PKWY STE 240
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-6103
Country	:	US
Telephone Number	:	817-735-4165
Fax Number	:	817-735-4688

Provider Business Practice Location Address
First Line	:	6551 HARRIS PKWY STE 240
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-6103
Country	:	US
Telephone Number	:	817-735-4165
Fax Number	:	817-735-4688

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	01/03/2024

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