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Individual

HERBERT A. PHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5323 HARRY HINES BLVD, E5-508, DALLAS, TX 75390-9158
(214) 648-6841
(214) 648-5477
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 648-6841
(214) 648-5477

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
26277
AL
2086S0127X
Trauma Surgery Physician
26277
AL
2086S0127X
Trauma Surgery Physician
Primary
L6574
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009981675
AL
05
009982245
AL
05
04551295
MS
05
272262300
FL
01
51526082
BLUE CROSS
AL
01
51526083
BLUE CROSS
AL
01
76-00405
UNITED HEALTH CARE
AL
Enumeration date
05/22/2006
Last updated
05/06/2013
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