Basic Information
Provider Information
NPI: 1730361221
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FARJO
FirstName: BASHAR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11511 SHADOW CREEK PKWY
Address2:  
City: PEARLAND
State: TX
PostalCode: 775847298
CountryCode: US
TelephoneNumber: 7134420000
FaxNumber:  
Practice Location
Address1: 2727 W HOLCOMBE BLVD
Address2:  
City: HOUSTON
State: TX
PostalCode: 770251669
CountryCode: US
TelephoneNumber: 7134420000
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/27/2007
LastUpdateDate: 06/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XN7420TXN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RS0012XN7420TXN Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
207R00000XN7420TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001XN7420TXY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
32760160305TX MEDICAID
8EB52201TXBLUE CROSS BLUE SHIELDOTHER
32760160405TX MEDICAID


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