Provider Demographics
NPI:1952344269
Name:FAILLACE, JOHN JOSPEH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSPEH
Last Name:FAILLACE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 WOODWAY DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6170
Mailing Address - Country:US
Mailing Address - Phone:254-732-0005
Mailing Address - Fax:
Practice Address - Street 1:7003 WOODWAY DR
Practice Address - Street 2:SUITE 302
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-6170
Practice Address - Country:US
Practice Address - Phone:254-732-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4106207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery