Provider Demographics
NPI:1568475960
Name:FALVEY, THOMAS S III (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:S
Last Name:FALVEY
Suffix:III
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 1:523 NORTH SANM HOUSTON PARKWAY EAST , SUITE #125
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060
Mailing Address - Country:US
Mailing Address - Phone:281-272-6277
Mailing Address - Fax:281-272-6281
Practice Address - Street 1:523 N SAM HOUSTON PKWY E STE 125
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-4011
Practice Address - Country:US
Practice Address - Phone:281-272-6277
Practice Address - Fax:281-272-6281
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6813207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032639902Medicaid
TX111433201OtherMEDICAID EPSDT
TX8B4651Medicare ID - Type Unspecified
TX032639902Medicaid