Provider Demographics
NPI:1538335765
Name:FW FARIS M D LTD
Entity type:Organization
Organization Name:FW FARIS M D LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:W
Authorized Official - Last Name:FARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-363-7756
Mailing Address - Street 1:609 CANYON GREENS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-0832
Mailing Address - Country:US
Mailing Address - Phone:702-363-7756
Mailing Address - Fax:
Practice Address - Street 1:609 CANYON GREENS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0832
Practice Address - Country:US
Practice Address - Phone:702-363-7756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7098207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty