Provider Demographics
NPI:1265241038
Name:FAIWISZEWSKI, NORA ELIZABETH (MED)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:ELIZABETH
Last Name:FAIWISZEWSKI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 HUNTERS WALK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2048
Mailing Address - Country:US
Mailing Address - Phone:301-704-0698
Mailing Address - Fax:
Practice Address - Street 1:5210 THOUSAND OAKS DR STE 1301
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-6974
Practice Address - Country:US
Practice Address - Phone:726-215-6448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician