Provider Demographics
NPI:1477658748
Name:FARROW, BUCKMINSTER J (MD)
Entity Type:Individual
Prefix:DR
First Name:BUCKMINSTER
Middle Name:J
Last Name:FARROW
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 1:13811 MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4903
Mailing Address - Country:US
Mailing Address - Phone:713-772-1200
Mailing Address - Fax:281-693-3522
Practice Address - Street 1:23920 KATY FWY STE 410
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1341
Practice Address - Country:US
Practice Address - Phone:713-772-1200
Practice Address - Fax:281-693-3522
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3535208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9609281OtherAETNA
TX2087546Medicaid
TXP00954962OtherMEDICARE RR
TX6735467OtherCIGNA
TX2087546Medicaid