Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | C4810 | TX |
NPI | 1225016579 |
---|---|
Provider Name | Dr. John A Ferris JR. |
First Address | Harlingen, TX 78550 |
Second Address | Harlingen, TX 78550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2006 |
Last Update Date | 16/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2287810 | BLUE CROSS (01) | TX |
741312646 | TAX I.D. (01) | TX |
B87810 | (02) | TX |