1134279896 NPI number — FARRIS, INC.

Table of content: (NPI 1134279896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134279896 NPI number — FARRIS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FARRIS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134279896
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6609 BLANCO RD
Provider Second Line Business Mailing Address:
SUITE 115
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78216-6131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-342-2299
Provider Business Mailing Address Fax Number:
210-342-5499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6609 BLANCO RD
Provider Second Line Business Practice Location Address:
SUITE 115
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78216-6131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-342-2299
Provider Business Practice Location Address Fax Number:
210-342-5499
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FARRIS
Authorized Official First Name:
LARRY
Authorized Official Middle Name:
W
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
210-342-2299

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  50938 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: 50522 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X , with the licence number: 50036 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X , with the licence number: 50238 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X , with the licence number: 50006 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X , with the licence number: 50426 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X , with the licence number: 50690 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X , with the licence number: 50688 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: 51259 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1980765-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2011306-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3053 . This is a "COMM 1ST" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0221178-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022408101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1994667-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2010936-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0221178-02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 022411501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 179378801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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