Provider Demographics
NPI:1194744011
Name:FEGHALI, GEORGES A (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGES
Middle Name:A
Last Name:FEGHALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:214-841-2000
Mailing Address - Fax:844-292-1458
Practice Address - Street 1:3409 WORTH ST STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2057
Practice Address - Country:US
Practice Address - Phone:214-841-2000
Practice Address - Fax:844-292-1458
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2071207R00000X, 207RI0011X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2800013-01Medicaid
TXI36145Medicare UPIN
TX2800013-01Medicaid