Provider Demographics
NPI:1467998401
Name:FAULK FAMILY HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:FAULK FAMILY HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:FAULK
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:409-727-1414
Mailing Address - Street 1:520 S TWIN CITY HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-4245
Mailing Address - Country:US
Mailing Address - Phone:409-727-1414
Mailing Address - Fax:409-727-1449
Practice Address - Street 1:520 S TWIN CITY HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-4245
Practice Address - Country:US
Practice Address - Phone:409-727-1414
Practice Address - Fax:409-727-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-15
Last Update Date:2017-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP116645363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty