Provider Demographics
NPI:1821004243
Name:FEIR, BETTY J (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:J
Last Name:FEIR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4099 SUMMERHILL SQ
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2768
Mailing Address - Country:US
Mailing Address - Phone:903-793-8588
Mailing Address - Fax:903-793-8589
Practice Address - Street 1:4099 SUMMERHILL SQ
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2768
Practice Address - Country:US
Practice Address - Phone:903-793-8588
Practice Address - Fax:903-793-8589
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21793103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81425POtherBLUE CROSS BLUE SHIELD
AR82825OtherBLUE CROSS BLUE SHIELD
TX81425PMedicare ID - Type Unspecified
R60500Medicare UPIN