MEDICARE: DR. SEBASTIAN FARO MD PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	G5898	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4237637	OTHER	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0093MH	OTHER	BCBS

General Provider Information

NPI Number	:	1356342315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEBASTIAN FARO MD PHD

Provider Business Mailing Address
First Line	:	7400 FANNIN ST
Second Line	:	#930
City	:	HOUSTON
State	:	TX
Zip	:	77054-1920
Country	:	US
Telephone Number	:	713-799-9091
Fax Number	:	713-799-9028

Provider Business Practice Location Address
First Line	:	7400 FANNIN ST
Second Line	:	#930
City	:	HOUSTON
State	:	TX
Zip	:	77054-1920
Country	:	US
Telephone Number	:	713-799-9091
Fax Number	:	713-799-9028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	10/30/2013

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