Provider Demographics
NPI:1710653183
Name:FALCON, ANECLETO III
Entity Type:Individual
Prefix:
First Name:ANECLETO
Middle Name:
Last Name:FALCON
Suffix:III
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 1:3611 ENNIS ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-4407
Mailing Address - Country:US
Mailing Address - Phone:832-393-4055
Mailing Address - Fax:
Practice Address - Street 1:3611 ENNIS ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-4407
Practice Address - Country:US
Practice Address - Phone:832-393-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator