Provider Demographics
NPI:1972188746
Name:FARCUS, GERALD L (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:L
Last Name:FARCUS
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 1:309 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5305
Mailing Address - Country:US
Mailing Address - Phone:512-861-5263
Mailing Address - Fax:
Practice Address - Street 1:309 WESTLAKE DR
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5305
Practice Address - Country:US
Practice Address - Phone:512-861-5263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-13
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3004207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty