Healthcare Provider Details
I. General information
NPI: 1114550621
Provider Name (Legal Business Name): ALICIA INEZ FAULKNER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/13/2020
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9645 BARKER CYPRESS RD STE 100
CYPRESS TX
77433-5292
US
IV. Provider business mailing address
5907 RANCH RIATA CT
KATY TX
77449-2047
US
V. Phone/Fax
- Phone: 346-250-6010
- Fax: 346-200-3572
- Phone: 512-508-2387
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 811894 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | 33490 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: