Provider Demographics
NPI:1942575279
Name:STEPHEN J FARMER, MD PA
Entity Type:Organization
Organization Name:STEPHEN J FARMER, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEHPHEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:817-571-6863
Mailing Address - Street 1:350 WESTPARK WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3731
Mailing Address - Country:US
Mailing Address - Phone:817-571-6863
Mailing Address - Fax:817-540-5775
Practice Address - Street 1:350 WESTPARK WAY STE 120
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3731
Practice Address - Country:US
Practice Address - Phone:817-571-6863
Practice Address - Fax:817-540-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB22634Medicare UPIN