Provider Demographics
NPI:1528841558
Name:FELDMAN, ALEXANDER RYUICHIRO
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:RYUICHIRO
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:RYUICHIRO
Other - Last Name:FELDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3302 GASTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2013
Mailing Address - Country:US
Mailing Address - Phone:214-828-8215
Mailing Address - Fax:
Practice Address - Street 1:3000 GASTON AVENUE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226
Practice Address - Country:US
Practice Address - Phone:214-828-8489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program