Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | N2496 | TX |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | N2496 | TX |
NPI | 1124137112 |
---|---|
Provider Name | Dr. Drew Mathew Fehsenfeld |
First Address | Houston, TX 77065-3840 |
Second Address | Cypress, TX 77429-5889 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 02/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8CA165 | BC/BS (01) | TX |