Provider Demographics
NPI:1215909593
Name:FEIGENBAUM, FRANK (M D)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:FEIGENBAUM
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 GREENVILLE AVE STE 1307
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-4026
Mailing Address - Country:US
Mailing Address - Phone:214-242-1389
Mailing Address - Fax:214-351-8451
Practice Address - Street 1:4925 GREENVILLE AVE STE 1307
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-4026
Practice Address - Country:US
Practice Address - Phone:214-242-1389
Practice Address - Fax:214-351-8451
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000155782174400000X
KS04-28677174400000X
TXP1751174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205038003Medicaid
KS100369440AMedicaid
MO205038003Medicaid
MOH24315Medicare UPIN
KS100369440AMedicaid
KSKA2588001Medicare PIN