Provider Demographics
NPI:1487040564
Name:FARMER, CAITLIN MACKENZIE (MD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:MACKENZIE
Last Name:FARMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CAITLIN
Other - Middle Name:MACKENZIE
Other - Last Name:FEARING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12700 PARK CENTRAL DR STE 1210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1522
Mailing Address - Country:US
Mailing Address - Phone:214-987-3376
Mailing Address - Fax:469-532-0273
Practice Address - Street 1:3200 BROADWAY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1571
Practice Address - Country:US
Practice Address - Phone:972-271-4141
Practice Address - Fax:972-278-8691
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR9609207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology