Individual
VECHESLAV FEDORCHENCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2800 TX-114, STE 350, TROPHY CLUB, TX 76262
(817) 674-7983
Mailing address
2800 TX-114, STE 350, TROPHY CLUB, TX 76262
(817) 674-7983
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R8350
TX
2084P0802X
Addiction Psychiatry Physician
R8350
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2017
Last updated
02/16/2023
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