Provider Demographics
NPI:1740508852
Name:F. GEORGE NIEBERG, M.D. AND ASSOCIATES, P.A.
Entity type:Organization
Organization Name:F. GEORGE NIEBERG, M.D. AND ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:F
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:NIEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-892-6392
Mailing Address - Street 1:425 N HIGHLAND
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092
Mailing Address - Country:US
Mailing Address - Phone:903-892-6392
Mailing Address - Fax:903-893-8819
Practice Address - Street 1:425 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7377
Practice Address - Country:US
Practice Address - Phone:903-892-6392
Practice Address - Fax:903-893-8819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4246174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB25160Medicare UPIN