MEDICARE: EMILE FARES M.D.

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
1	207Q00000X	Family Medicine Physician	G2254	TX
2	207R00000X	Internal Medicine Physician	G2254	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902891302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILE FARES M.D.

Provider Business Mailing Address
First Line	:	7338 MCHENRY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-3633
Country	:	US
Telephone Number	:	713-644-4442
Fax Number	:	713-644-8964

Provider Business Practice Location Address
First Line	:	7338 MCHENRY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-3633
Country	:	US
Telephone Number	:	713-644-4442
Fax Number	:	713-644-8964

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	02/04/2015

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Directions to “ EMILE FARES M.D.” Practice Location

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