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Individual

BRIAN KEITH FAHEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0865
(972) 233-1999
(972) 233-3666

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H8028
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050069934
RAILROAD MEDICARE
TX
05
118646202
TX
01
8018J5
OUT OF HARRIS - MEDICARE
TX
01
84Y543
IN HARRISS - MEDICARE
TX
01
84Y543
TX-BLUE SHIELD
Enumeration date
01/09/2007
Last updated
06/25/2021
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