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NPI Code Detail

MEDICARE: DR. RICHARD WILLIAM FARNAM MD

MEDICARE: DR. RICHARD WILLIAM FARNAM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) PhysicianM0459TX
2207VG0400XGynecology PhysicianM4059TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18BZ576OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1205818234
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD WILLIAM FARNAM MD
Provider Business Mailing Address
First Line : 4501 N MESA ST
Second Line :
City : EL PASO
State : TX
Zip : 79912-6101
Country : US
Telephone Number : 915-533-5600
Fax Number : 915-533-5604
Provider Business Practice Location Address
First Line : 4501 N MESA ST
Second Line :
City : EL PASO
State : TX
Zip : 79912-6101
Country : US
Telephone Number : 915-533-5600
Fax Number : 915-533-5604
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 10/29/2021

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