Provider Demographics
NPI:1629171764
Name:FALEYE, TERRY I (PA-C)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:I
Last Name:FALEYE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19701 KINGWOOD DR STE 6
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3773
Mailing Address - Country:US
Mailing Address - Phone:281-359-6000
Mailing Address - Fax:281-359-8006
Practice Address - Street 1:19701 KINGWOOD DR STE 6
Practice Address - Street 2:SUITE 140
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3773
Practice Address - Country:US
Practice Address - Phone:281-359-6000
Practice Address - Fax:281-359-8006
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04167363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y1847OtherBCBS
TX189518701Medicaid
TX8Y1847OtherBCBS
TX8G4911Medicare ID - Type Unspecified
TXP00690726Medicare PIN
TX8G9900Medicare PIN