Provider Demographics
NPI:1619149549
Name:MOSHE FELDHENDLER, MD PA
Entity Type:Organization
Organization Name:MOSHE FELDHENDLER, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENATIVE/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDHENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-500-5755
Mailing Address - Street 1:PO BOX 797947
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-7947
Mailing Address - Country:US
Mailing Address - Phone:214-500-5288
Mailing Address - Fax:972-677-7769
Practice Address - Street 1:6815 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5817
Practice Address - Country:US
Practice Address - Phone:214-500-5288
Practice Address - Fax:972-677-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1991408-01Medicaid
TX0042RTOtherBCBS
TX1991408-01Medicaid