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General NPI Number Information
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NPI Number | 1649407370
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Entity Type | Individual
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Provider Name | SCOTT JEREMY FARBER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2009
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 4 DOMINION DR BLDG 1
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1390
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Country | US
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Telephone | 210-658-3555
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Fax | 210-362-1582
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Provider Business Mailing Address
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Address Line | 17503 LA CANTERA PARKWAY SUITE 104 BOX 184
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City | SAN ANTONIO
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State | TX
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Zip | 78257-9401
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Country | US
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Telephone | 210-658-3555
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Fax | 210-362-1582
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 287346
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | R8558
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License Number State | TX
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