Fairbanks, John Lawrence
Fairbanks, John Lawrence is an individual health care provider with primary practice located at 4370 Medical Arts Dr Suite 105, Flower Mound TX 75028-1712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Fairbanks, John Lawrence can be contacted via phone (214) 394-4500.Contact Information
Primary practice address
4370 Medical Arts Dr Suite 105
Flower Mound TX 75028-1712
Phone: (214) 394-4500
Fax: (214) 513-2059
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | J9018 | Texas |
Profile Details
| NPI number | 1376645283 |
|---|---|
| LBN Legal business name | Fairbanks, John Lawrence |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2006 |
| Last updated | Jan 31st, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376645283 | NPPES |
| Texas | MEDICAID | 117289212 | |
| Texas | MEDICAID | 117289211 | |
| Texas | Other | P01601410 |
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