Healthcare Provider Details

I. General information

NPI: 1992973648
Provider Name (Legal Business Name): HARRY LOUIS FAUST JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 RUNNELS ST
BIG SPRING TX
79720-2527
US

IV. Provider business mailing address

307 CHARLESTON ST
FRIENDSWOOD TX
77546-4923
US

V. Phone/Fax

Practice location:
  • Phone: 432-263-0027
  • Fax: 432-264-4210
Mailing address:
  • Phone: 281-482-4312
  • Fax: 281-482-4350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberE 0905
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE0905
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: