Provider Demographics
NPI:1861784399
Name:FARBER, ADAM JEFFERY (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:JEFFERY
Last Name:FARBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79760-2129
Mailing Address - Country:US
Mailing Address - Phone:432-337-3117
Mailing Address - Fax:432-640-6366
Practice Address - Street 1:540 W 5TH ST STE 460
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761
Practice Address - Country:US
Practice Address - Phone:432-337-3117
Practice Address - Fax:432-640-6366
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7433207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology