Basic Information
Provider Information
NPI: 1770082919
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FEIGIN
FirstName: MICHAEL
MiddleName: ERIC
NamePrefix: MR.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124724357
FaxNumber: 5127031394
Practice Location
Address1: 6600 E BEN WHITE BLVD
Address2:  
City: AUSTIN
State: TX
PostalCode: 787417537
CountryCode: US
TelephoneNumber: 5128043745
FaxNumber: 5124404059
Other Information
ProviderEnumerationDate: 02/02/2018
LastUpdateDate: 02/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X766914TXY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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