Provider Demographics
NPI:1184831984
Name:FENOY, ALBERT JOHN JR (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:JOHN
Last Name:FENOY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2070
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1541
Mailing Address - Country:US
Mailing Address - Phone:713-486-7747
Mailing Address - Fax:
Practice Address - Street 1:18955 N MEMORIAL DR STE 340
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4263
Practice Address - Country:US
Practice Address - Phone:713-486-7780
Practice Address - Fax:713-486-7794
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA37978207T00000X
TXN3027207T00000X
IAR-6833207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00705645Medicare PIN
IAI09230015Medicare PIN
TX8L17264Medicare PIN