Provider Demographics
NPI:1720707037
Name:FEUCHTER, ONNA (APRN, FNP-C, FNP-BC)
Entity Type:Individual
Prefix:
First Name:ONNA
Middle Name:
Last Name:FEUCHTER
Suffix:
Gender:F
Credentials:APRN, FNP-C, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10028 TULE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-1422
Mailing Address - Country:US
Mailing Address - Phone:915-875-7112
Mailing Address - Fax:
Practice Address - Street 1:415 E SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6250
Practice Address - Country:US
Practice Address - Phone:817-416-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX765159163WS0121X
TX1048142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery