Provider Demographics
NPI:1508155987
Name:FARO, JONATHAN P (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:P
Last Name:FARO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 GESSNER RD STE 760
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2560
Mailing Address - Country:US
Mailing Address - Phone:713-465-1800
Mailing Address - Fax:833-396-2487
Practice Address - Street 1:915 GESSNER RD STE 760
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2560
Practice Address - Country:US
Practice Address - Phone:713-465-1800
Practice Address - Fax:833-396-2487
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXN9853207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program