Basic Information
Provider Information
NPI: 1841386976
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCFARLANE
FirstName: JOHN
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3705 MEDICAL PKWY
Address2: SUITE 320
City: AUSTIN
State: TX
PostalCode: 787051019
CountryCode: US
TelephoneNumber: 5124540392
FaxNumber: 5124541233
Practice Location
Address1: 3705 MEDICAL PKWY
Address2: SUITE 320
City: AUSTIN
State: TX
PostalCode: 787051019
CountryCode: US
TelephoneNumber: 5124540392
FaxNumber: 5124541233
Other Information
ProviderEnumerationDate: 10/05/2006
LastUpdateDate: 09/26/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XD6092TXY Allopathic & Osteopathic PhysiciansOtolaryngology 

ID Information
IDTypeStateIssuerDescription
12732940605TX MEDICAID
12732940105TX MEDICAID
80448801TXBCBSOTHER


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