Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | L9192 | TX |
Y | 208200000X | Surgeon | L9192 | TX |
Y | 208600000X | Surgeon | L9192 | TX |
N | 2086S0127X | Trauma Surgeon | L9192 | TX |
NPI | 1407892334 |
---|---|
Provider Name | Dr. Jose Farias-Jimenez |
First Address | Malvern, PA 19355-0746 |
Second Address | Mcallen, TX 78501-2922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 26/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
166146403 | (05) | TX |
1661464-04 | (05) | TX |
183631401 | (05) | TX |
8AL310 | BCBS (01) | TX |
I11451 | (02) | TX |
P00707052 | RAILROAD MEDICARE (01) | TX |