Organization
JEFFREY A FEARON MD P A
Active
Other names
The Craniofacial Center
Organization subpart
No
Provider details
NPI number
Authorized official
ALONDRA E TIPPS MBA CFO CMOM (PRACTICE ADMINISTRATOR)
(972) 566-6464
Entity
Organization
Contact information
Practice address
7777 FOREST LN STE C700, DALLAS, TX 75230-2518
(972) 566-6464
(972) 566-6279
Mailing address
7777 FOREST LN STE C700, DALLAS, TX 75230-2518
(972) 566-6464
(972) 566-6279
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
H8638
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093725201
—
TX
Enumeration date
02/02/2007
Last updated
02/16/2017
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