Provider Demographics
NPI:1528396843
Name:F FARIS MD LTD
Entity Type:Organization
Organization Name:F FARIS MD LTD
Other - Org Name:FRONTIER GASTROENTEROLOGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:FARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-858-9158
Mailing Address - Street 1:PO BOX 34027
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-4027
Mailing Address - Country:US
Mailing Address - Phone:702-483-5515
Mailing Address - Fax:702-483-5484
Practice Address - Street 1:2701 N TENAYA WAY STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0479
Practice Address - Country:US
Practice Address - Phone:702-483-5515
Practice Address - Fax:702-483-5484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7098207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1528396843Medicaid
NVDG312AMedicare PIN