Provider Demographics
NPI:1205368602
Name:FAHEY, JAMES NICHOLAS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:NICHOLAS
Last Name:FAHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2102 TREASURE HILLS BLVD # 3.14406
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8736
Mailing Address - Country:US
Mailing Address - Phone:956-296-1437
Mailing Address - Fax:956-296-6842
Practice Address - Street 1:3804 S JACKSON RD STE 2
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6683
Practice Address - Country:US
Practice Address - Phone:956-296-3021
Practice Address - Fax:956-296-3020
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH08MV75001OtherBCBS