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General NPI Number Information
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NPI Number | 1699924209
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Entity Type | Organization
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Legal Business Name | EMILE FARES M.D. PA
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 1398 ELDRIDGE PKWY SUITE 113
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City | HOUSTON
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State | TX
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Zip | 77077-1692
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Country | US
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Telephone | 281-679-9500
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Fax | 281-679-9501
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Provider Business Mailing Address
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Address Line | 7338 MCHENRY ST
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City | HOUSTON
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State | TX
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Zip | 77087-3633
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Country | US
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Telephone | 713-644-4442
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Fax | 713-644-8964
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. EMILE FARES
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Credential | M.D.
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Telephone | 713-644-4442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | G2254
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G2254
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License Number State | TX
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