Provider Demographics
NPI:1013084102
Name:FAUGHT, DARRELL D (DDS)
Entity type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:D
Last Name:FAUGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 SUNRISE RD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-2497
Mailing Address - Country:US
Mailing Address - Phone:512-255-3761
Mailing Address - Fax:512-255-3762
Practice Address - Street 1:2608 SUNRISE RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2497
Practice Address - Country:US
Practice Address - Phone:512-255-3761
Practice Address - Fax:512-255-3762
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD168271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice