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NPI Code Detail

MEDICARE: CARSON L FAIRBANKS M.D.

MEDICARE: CARSON L FAIRBANKS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianQ7686TX
2207XS0117XOrthopaedic Surgery of the Spine PhysicianQ7686TX

General Provider Information

NPI Number : 1528324118
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARSON L FAIRBANKS M.D.
Provider Business Mailing Address
First Line : 6301 HARRIS PKWY STE 200
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4265
Country : US
Telephone Number : 817-433-3450
Fax Number : 817-294-6429
Provider Business Practice Location Address
First Line : 5900 ALTAMESA BLVD STE 100
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-5475
Country : US
Telephone Number : 817-854-9969
Fax Number : 817-845-9965
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2012
Last Update Date : 04/22/2025

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Directions to “ CARSON L FAIRBANKS M.D.” Practice Location

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