Organization
MIRHASSAN FARIVAR, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRHASSAN FARIVAR M.D. (PHYSICIAN/OWNER)
(210) 587-8888
Entity
Organization
Contact information
Practice address
414 NAVARRO ST, 1033, SAN ANTONIO, TX 78205-2516
(210) 587-8888
(210) 587-8889
Mailing address
PO BOX 17650, SAN ANTONIO, TX 78217-0650
(210) 587-8888
(210) 587-8889
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
J3465
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196762201
—
TX
Enumeration date
06/06/2008
Last updated
07/16/2012
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