Provider Demographics
NPI:1417954819
Name:FASS, OREN N (MD)
Entity Type:Individual
Prefix:
First Name:OREN
Middle Name:N
Last Name:FASS
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 1:2301 S HAMPTON RD STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75224-1654
Mailing Address - Country:US
Mailing Address - Phone:214-330-3937
Mailing Address - Fax:214-330-3939
Practice Address - Street 1:2301 S HAMPTON RD STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-1654
Practice Address - Country:US
Practice Address - Phone:214-330-3937
Practice Address - Fax:214-330-3939
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0758207W00000X, 207WX0120X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA257628OtherCOVENTRY HMO
GA513957OtherBCBS
GA575607154CMedicaid
TX575607154Medicaid
GA575607154AMedicaid
GA10061047OtherAMERIGROUP
GA3704635OtherAETNA HMO
GA575607154BMedicaid
GA906070OtherCOVENTRY PPO
GA373517OtherBCBS
GA951740OtherBCBS
GA7325471OtherAETNA
GA0800646OtherUHC
GA294525OtherWELLCARE
GAP00222036OtherRR MEDICARE
TX18BDGJLMedicare PIN
GA951740OtherBCBS
GA3704635OtherAETNA HMO
GA575607154AMedicaid
GA575607154BMedicaid
GA10061047OtherAMERIGROUP
GA294525OtherWELLCARE
GA575607154CMedicaid