Provider Demographics
NPI:1992027874
Name:FASSER, CARL EMIL (PA)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:EMIL
Last Name:FASSER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11929 EAST FWY STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-2026
Mailing Address - Country:US
Mailing Address - Phone:713-637-8665
Mailing Address - Fax:713-637-8658
Practice Address - Street 1:11929 EAST FWY STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-2026
Practice Address - Country:US
Practice Address - Phone:713-637-8665
Practice Address - Fax:713-637-8658
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00114363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant