Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | G2698 | TX |
N | 207RX0202X | Medical Oncology | G2698 | TX |
NPI | 1144264078 |
---|---|
Provider Name | Dr. Joseph W. Fay |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75246-2003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 12/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000L1245 | (05) | NM |
100031920A | (05) | OK |
134351903 | (05) | TX |
134351906 | (05) | TX |
134351908 | (05) | TX |
8R1437 | BLUE CROSS OF TEXAS (01) | TX |
C15592 | (02) | TX |