Individual
MR. JEFFREY J. FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7777 FOREST LN STE D569, DALLAS, TX 75230-6903
(972) 566-8340
(972) 566-8338
Mailing address
PO BOX 515055, DALLAS, TX 75251-5055
(972) 566-8340
(972) 566-8338
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
01096987A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
48843
WI
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
N1317
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204410903
—
TX
05
—
34843900
—
WI
Enumeration date
06/07/2006
Last updated
08/11/2025
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