Provider Demographics
NPI:1437839099
Name:FALKNOR, DAVID WILSON JR
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WILSON
Last Name:FALKNOR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12307 DRAKE PRAIRIE LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3889
Mailing Address - Country:US
Mailing Address - Phone:832-353-8031
Mailing Address - Fax:
Practice Address - Street 1:12850 JONES RD STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4956
Practice Address - Country:US
Practice Address - Phone:832-353-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT117302225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist