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General NPI Number Information
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NPI Number | 1154853992
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Entity Type | Organization
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Legal Business Name | FARINO PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 03/31/2017
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 8800 VILLAGE DR SUITE 209
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5412
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Country | US
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Telephone | 210-202-0100
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Fax | 210-579-9705
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Provider Business Mailing Address
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Address Line | 516 NOLAN ST
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City | SAN ANTONIO
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State | TX
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Zip | 78202-2250
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Country | US
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Telephone | 512-550-3380
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JETHER CHRISTIAN FARINO
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Credential | M.D.
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Telephone | 512-550-3380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | R1749
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License Number State | TX
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