Organization
GERALD FANAROF, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD FANAROF M.D. (PRESIDENT)
(281) 589-1960
Entity
Organization
Contact information
Practice address
12121 RICHMOND AVE, SUITE 111, HOUSTON, TX 77082-2432
(281) 589-1960
(281) 589-1961
Mailing address
12121 RICHMOND AVE, SUITE 111, HOUSTON, TX 77082-2432
(281) 589-1960
(281) 589-1961
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
F0181
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033846901
—
TX
Enumeration date
12/16/2009
Last updated
03/26/2015
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