Provider Demographics
NPI:1184814493
Name:FARINETTI, FABIANA ZIEGLER (MD)
Entity Type:Individual
Prefix:
First Name:FABIANA
Middle Name:ZIEGLER
Last Name:FARINETTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FABIANA
Other - Middle Name:
Other - Last Name:ZIEGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17903 W LAKE HOUSTON PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3954
Mailing Address - Country:US
Mailing Address - Phone:281-812-1846
Mailing Address - Fax:281-812-2778
Practice Address - Street 1:17903 W LAKE HOUSTON PKWY STE 201
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3954
Practice Address - Country:US
Practice Address - Phone:281-812-1846
Practice Address - Fax:281-812-2778
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ2278208000000X, 207R00000X
OH35096218207R00000X
LA56302207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100148120Medicaid
OH3108363Medicaid
WV3810019468Medicaid
KYP400036349Medicare PIN
OH3108363Medicaid