Provider Demographics
NPI:1740228717
Name:STEVEN H FEHRENKAMP MD PA
Entity Type:Organization
Organization Name:STEVEN H FEHRENKAMP MD PA
Other - Org Name:AUSTIN ENDOCRINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:HARRY
Authorized Official - Last Name:FEHRENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-445-2833
Mailing Address - Street 1:4007 JAMES CASEY
Mailing Address - Street 2:A230
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745
Mailing Address - Country:US
Mailing Address - Phone:512-445-2833
Mailing Address - Fax:512-445-4121
Practice Address - Street 1:4007 JAMES CASEY
Practice Address - Street 2:A230
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-445-2833
Practice Address - Fax:512-445-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8463207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0063MHOtherBLUE CROSS BLUE SHIELD
TX00611YMedicare ID - Type Unspecified
TX0063MHOtherBLUE CROSS BLUE SHIELD