Healthcare Provider Details

I. General information

NPI: 1720012172
Provider Name (Legal Business Name): JOSE M FARINA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BROOKLYN AVE 220
SAN ANTONIO TX
78212-4803
US

IV. Provider business mailing address

306 HARVARD OAK
SAN ANTONIO TX
78230
US

V. Phone/Fax

Practice location:
  • Phone: 210-228-0705
  • Fax: 210-472-0255
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberH5877
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: