Provider Demographics
NPI:1245262484
Name:FAIGIN, NANCY G (DO)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:G
Last Name:FAIGIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:N
Other - Middle Name:G
Other - Last Name:FAIGIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:5703 WEST CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-3395
Mailing Address - Country:US
Mailing Address - Phone:817-294-0731
Mailing Address - Fax:817-294-8065
Practice Address - Street 1:5703 WEST CREEK DR
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-3395
Practice Address - Country:US
Practice Address - Phone:817-294-0731
Practice Address - Fax:817-294-8065
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A66298Medicare UPIN
TX8287K1Medicare ID - Type Unspecified