Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | L2882 | TX |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | L2882 | TX |
NPI | 1053303131 |
---|---|
Provider Name | Tommie Farrell |
First Address | Abilene, TX 79604-1198 |
Second Address | Abilene, TX 79601-2432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 13/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100222280A | (05) | OK |
112530101 | FIRSTCARE COMMERCIAL (01) | TX |
112530102 | (05) | TX |
149118501 | (05) | TX |
149118502 | (05) | TX |
81199 | (05) | NM |
81199 | PRESBYTERIAN COMMERCIAL (01) | NM |
87397Z | HMO BLUE (01) | TX |
88616Z | BLUE CROSS / BLUE SHIELD (01) | TX |
98102001 | (05) | NM |
B024 | TRIWEST (01) | NM |
H54875 | (02) | TX |