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General NPI Number Information
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NPI Number | 1891083630
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Entity Type | Organization
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Legal Business Name | KARANA R. FAIRLEY, M.D., P.A.
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 3801 W 15TH ST STE 350B
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City | PLANO
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State | TX
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Zip | 75075-7723
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Country | US
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Telephone | 972-867-9300
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Fax | 972-867-1700
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Provider Business Mailing Address
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Address Line | 3801 W 15TH ST STE 350B
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City | PLANO
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State | TX
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Zip | 75075-7723
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Country | US
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Telephone | 972-867-9300
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Fax | 972-867-1700
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | ADRIANE ALEXANDER
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Credential |
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Telephone | 972-867-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L0160
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License Number State | TX
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