Individual
DR. NEVILLE F. FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 TUSCAN, SUITE #110, IRVING, TX 75039-3834
(214) 496-1100
(214) 496-1110
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2213
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
K4888
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135836808
—
TX
01
—
8303J1
BCBS
TX
Enumeration date
12/21/2005
Last updated
05/23/2013
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