| Doctor Name: | DR. DAVID JOHN FEDRO |
| NPI Number: | 1710957048 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | G3347 |
| Business Practice Address: | 688 Alliance Pkwy Suite #201 Hewitt, TX - 766433585 |
| Business Phone Number: | 2543004399 |
| Business Fax Number: | 2543004401 |
| Mailing Address: | 688 Alliance Pkwy, Suite #201 HEWITT |
| State: | TX |
| Postal Code: | 766433585 |
| Phone Number: | 2543004399 |
| Fax Number: | 2543004401 |
| NPI Enumeration Date: | 01/26/2006 |
| NPI Last Update Date: | 11/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G3347 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |