Provider Demographics
NPI:1073528485
Name:FAIRMONT MEDICAL CLINIC , PA
Entity Type:Organization
Organization Name:FAIRMONT MEDICAL CLINIC , PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCOIS FERRON
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-947-9955
Mailing Address - Street 1:PO BOX 891305
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77289-1305
Mailing Address - Country:US
Mailing Address - Phone:713-947-9955
Mailing Address - Fax:713-910-5969
Practice Address - Street 1:3801 VISTA RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2159
Practice Address - Country:US
Practice Address - Phone:713-947-9955
Practice Address - Fax:713-910-5969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730162603OtherNPI FOR FRANCOIS FERRON
TX00273ROtherMEDICARE PROVIDER NUMBER FOR FAIRMONT MEDICAL CLINIC, PA
1376526285OtherNPI FOR JOSEE LALIBERTE
TX1952390502OtherNPI FOR CHARLES BESSIRE
TX8581M1OtherMEDICARE PROVIDER NUMBER DR FRANCOIS FERRON
TX8581M0OtherMEDICARE PROVIDER NUMBER FOR DR JOSEE LALIBERTE
G26933Medicare UPIN
TX8K3474Medicare PIN
TX8581M1OtherMEDICARE PROVIDER NUMBER DR FRANCOIS FERRON
TX1952390502OtherNPI FOR CHARLES BESSIRE