Doctor Name: | ROBERT W. FARRIS |
NPI Number: | 1245422096 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APRN,BC |
License Number: | 594549 |
Business Practice Address: | 204 S. 4th Street Ganado, TX - 77962 |
Business Phone Number: | 3617713311 |
Business Fax Number: | 3617713081 |
Mailing Address: | 204 S. 4th Street, GANADO |
State: | TX |
Postal Code: | 77962 |
Phone Number: | 3617713311 |
Fax Number: | 3617713081 |
NPI Enumeration Date: | 08/15/2007 |
NPI Last Update Date: | 08/15/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 594549 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |