Provider Demographics
NPI:1275542144
Name:ELFARR, WILLIAM ALEX (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALEX
Last Name:ELFARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1701 SOUTH PALESTINE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-5739
Mailing Address - Country:US
Mailing Address - Phone:903-675-9339
Mailing Address - Fax:903-675-9344
Practice Address - Street 1:1701 SOUTH PALESTINE
Practice Address - Street 2:SUITE A
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-5739
Practice Address - Country:US
Practice Address - Phone:903-675-9339
Practice Address - Fax:903-675-9344
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7275208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX340016744OtherRAILROAD MEDICARE
TX0449779-01Medicaid
8856N1OtherBCBS
TX8856N1OtherMEDICARE
TX7299015OtherAETNA
TX0449779-01Medicaid