Provider Demographics
NPI:1679611081
Name:FEHR, JAMES W (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:FEHR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3398 N 1ST ST STE B
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79603-7055
Mailing Address - Country:US
Mailing Address - Phone:325-672-1011
Mailing Address - Fax:325-672-0903
Practice Address - Street 1:3398 N 1ST ST STE B
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79603-7055
Practice Address - Country:US
Practice Address - Phone:325-672-1011
Practice Address - Fax:325-672-0903
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2459T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093423402Medicaid
TX093423402Medicaid
TXT13246Medicare UPIN