Provider Demographics
NPI:1205818234
Name:FARNAM, RICHARD WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:FARNAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 N MESA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6101
Mailing Address - Country:US
Mailing Address - Phone:915-533-5600
Mailing Address - Fax:915-533-5604
Practice Address - Street 1:4501 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6101
Practice Address - Country:US
Practice Address - Phone:915-533-5600
Practice Address - Fax:915-533-5604
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM04592088F0040X
TXM4059207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BZ576OtherBLUE CROSS BLUE SHIELD
TXI32217Medicare UPIN
TX8BZ576OtherBLUE CROSS BLUE SHIELD