Healthcare Provider Details
I. General information
NPI: 1124448972
Provider Name (Legal Business Name): DREW FARMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/20/2014
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 S MAIN ST
FT WORTH TX
76104-4917
US
IV. Provider business mailing address
8230 WALNUT HILL LN STE 320
DALLAS TX
75231-4481
US
V. Phone/Fax
- Phone: 817-702-1100
- Fax:
- Phone: 214-369-5432
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | MD468280 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0127X |
| Taxonomy | Trauma Surgery Physician |
| License Number | MD468280 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0102X |
| Taxonomy | Surgical Critical Care Physician |
| License Number | T3275 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: