Provider Demographics
NPI:1790736494
Name:FENRICH, ARNOLD L JR (MD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:L
Last Name:FENRICH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4314 MEDICAL PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3334
Mailing Address - Country:US
Mailing Address - Phone:512-454-1110
Mailing Address - Fax:512-374-1354
Practice Address - Street 1:4314 MEDICAL PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3334
Practice Address - Country:US
Practice Address - Phone:512-454-1110
Practice Address - Fax:512-374-1354
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2010-10-27
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Provider Licenses
StateLicense IDTaxonomies
TXJ25572080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1356479Medicaid
F34681Medicare UPIN