Provider Demographics
NPI:1740225960
Name:FELLDMAN, BERNARD HARRY (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:HARRY
Last Name:FELLDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1740 W 27TH ST
Mailing Address - Street 2:SIUTE 215
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1440
Mailing Address - Country:US
Mailing Address - Phone:713-869-7491
Mailing Address - Fax:713-869-3708
Practice Address - Street 1:1740 W 27TH ST
Practice Address - Street 2:SIUTE 215
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1440
Practice Address - Country:US
Practice Address - Phone:713-869-7491
Practice Address - Fax:713-869-3708
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1415208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R0740OtherBLUE CROSS BLUE SHIELD
TX8C9906Medicare ID - Type Unspecified
D49597Medicare UPIN