Provider Demographics
NPI:1043285513
Name:FARR, BRIAN K (MA, ATC, LAT, CSCS)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:K
Last Name:FARR
Suffix:
Gender:M
Credentials:MA, ATC, LAT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 RED TAILED HAWK DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-8070
Mailing Address - Country:US
Mailing Address - Phone:512-471-9885
Mailing Address - Fax:512-471-0946
Practice Address - Street 1:2100 SAN JACINTO BLVD
Practice Address - Street 2:BEL 222 D3700
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78712-1047
Practice Address - Country:US
Practice Address - Phone:512-471-9885
Practice Address - Fax:512-471-0946
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT 23032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer