Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | N0013 | TX |
NPI | 1003003963 |
---|---|
Provider Name | Dr. Cyrus Richard Farahani |
First Address | Austin, TX 78752-3843 |
Second Address | Smithville, TX 78957-1730 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 23/08/2011 |