Organization
ROBERT W FARRELL MD PA
Active
Parent organization
ROBERT W FARRELL MD PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROBERT W FARRELL MD PA
Authorized official
ROBERT W FARRELL MD (PHYSICIAN/OWNER)
(281) 316-0331
Entity
Organization
Contact information
Practice address
450 BLOSSOM ST. SUITE G, WEBSTER, TX 77598
(281) 316-0331
(281) 316-0200
Mailing address
450 BLOSSOM ST. SUITE G, WEBSTER, TX 77598
(281) 316-0331
(281) 316-0200
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G2697
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011427316
TRICARE
TX
01
—
10013103
AMERIGROUP
TX
05
—
122242403
—
TX
01
—
20014
HERITAGE
TX
01
—
926228
AETNA
TX
05
—
P00049BP8
—
TX
01
—
S01503
BLUE LINK
TX
01
—
TXB165523
HMO BLUE
TX
Enumeration date
09/11/2012
Last updated
12/10/2012
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