Provider Demographics
NPI:1922647692
Name:FARES, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:FARES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6870 KING RANCH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-3465
Mailing Address - Country:US
Mailing Address - Phone:682-472-7415
Mailing Address - Fax:
Practice Address - Street 1:6150 GLENVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-2125
Practice Address - Country:US
Practice Address - Phone:682-472-7415
Practice Address - Fax:610-612-3449
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1247715225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist