Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | T1353 | TX |
NPI | 1023423852 |
---|---|
Provider Name | Munes Fares |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2014 |
Last Update Date | 03/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
277389 | (05) | OH |