Provider Demographics
NPI:1619411618
Name:XIE, FEI
Entity Type:Individual
Prefix:
First Name:FEI
Middle Name:
Last Name:XIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 BALBOA CT
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-3215
Mailing Address - Country:US
Mailing Address - Phone:817-714-4760
Mailing Address - Fax:
Practice Address - Street 1:3801 WILLIAM D TATE AVE STE 105
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8755
Practice Address - Country:US
Practice Address - Phone:817-488-6812
Practice Address - Fax:817-251-1303
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-09
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX720883363L00000X
TXAP132641363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner