Healthcare Provider Details

I. General information

NPI: 1770532236
Provider Name (Legal Business Name): THOMAS J FALTERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1990 INDUSTRIAL BLVD
HOUMA LA
70363-7055
US

IV. Provider business mailing address

302 HACKER ST
NEW IBERIA LA
70560-4508
US

V. Phone/Fax

Practice location:
  • Phone: 985-868-9300
  • Fax: 985-851-0053
Mailing address:
  • Phone: 337-330-2576
  • Fax: 337-321-6295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number024921
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.024921
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: