Fane, Larry Ralph

Fane, Larry Ralph is an individual health care provider with primary practice located at 612 E University Ave , Georgetown TX 78626-7034. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Fane, Larry Ralph can be contacted via phone (512) 930-5437.

Contact Information

Primary practice address
612 E University Ave Georgetown TX 78626-7034
Phone: (512) 930-5437
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X D7566 Texas

Profile Details

NPI number 1992754345
LBN Legal business name Fane, Larry Ralph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Mar 9th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992754345 NPPES
Texas MEDICAID 1309775-01

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