Provider Demographics
NPI:1205858834
Name:FLETCHER, REX ALBERT (MD, PA)
Entity type:Individual
Prefix:MR
First Name:REX
Middle Name:ALBERT
Last Name:FLETCHER
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3501 S. SONCY
Mailing Address - Street 2:STE 110
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6405
Mailing Address - Country:US
Mailing Address - Phone:806-353-1400
Mailing Address - Fax:806-353-1404
Practice Address - Street 1:3501 S. SONCY
Practice Address - Street 2:STE 110
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6405
Practice Address - Country:US
Practice Address - Phone:806-353-1400
Practice Address - Fax:806-353-1404
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2016-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK3187208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG31353Medicare UPIN
TX092290801Medicaid
TX060237701Medicaid
TX092290802Medicaid