Provider Demographics
NPI:1376504704
Name:DE FEX, ARMANDO JOSE (MD)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:JOSE
Last Name:DE FEX
Suffix:
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 1:800 N BISHOP AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4203
Mailing Address - Country:US
Mailing Address - Phone:214-941-0801
Mailing Address - Fax:214-941-2161
Practice Address - Street 1:800 N BISHOP AVE STE 2
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4203
Practice Address - Country:US
Practice Address - Phone:214-941-0801
Practice Address - Fax:214-941-2161
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092284101Medicaid
G80524Medicare UPIN
TX092284101Medicaid