| NPI Details | |
|---|---|
| NPI | 1124061304 |
| Enumeration Date | 06/14/2006 |
| Last Updated | 02/06/2015 |
| Entity Type | Healthcare Provider |
| Active | Over 12 years ago |
| Authorized Information | |
|---|---|
| Name | GARY GARY |
| Position | MANAGING MEMBER |
| Phone | (903) 389-1236 |
| Fax | (903) 389-1241 |
| Practice Location | |
|---|---|
| 420 MOODY ST FAIRFIELD TX, 75840-3036, US |
|
| Phone | (903) 389-1236 |
| Fax | (903) 389-1241 |
| Business Location | |
|---|---|
| 420 MOODY ST FAIRFIELD TX, 75840-3036, US |
|
| Phone | |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 314000000X |
| License State | Texas |
| License Number | 102704 |
| Remove 1124061304 NPI Number | |
According to our database, Fairfield I Enterprises, Llc NPI is 1124061304, taxonomy code is 314000000X and license number is 102704, license state is located at Texas. Fairfield I Enterprises, Llc physically located at 420 Moody St, Fairfield TX, 75840-3036. NPI Number 1033115704 has the healthcare provider type.
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1124061304 NPI number is provided on an as is basis without warranty of any kind. 1124061304 is maintained by the National Plan & Provider Enumeration System. The contents of Fairfield I Enterprises, Llc are for informational purposes only.
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