Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K7072 | TX |
Y | 208600000X | Surgeon | K7072 | TX |
NPI | 1003822362 |
---|---|
Provider Name | Kevin P O'farrell |
First Address | Austin, TX 78723-1142 |
Second Address | Austin, TX 78731-3166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 20/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020040564 | (05) | TX |
040536701 | (05) | TX |
040536702 | (05) | TX |
040536703 | (05) | TX |