Healthcare Provider Details

I. General information

NPI: 1457486227
Provider Name (Legal Business Name): ROBERT W. FAYLE, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 11/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 HERMANN DR SUITE #715
HOUSTON TX
77004-7018
US

IV. Provider business mailing address

1213 HERMANN DR SUITE #715
HOUSTON TX
77004-7018
US

V. Phone/Fax

Practice location:
  • Phone: 713-529-1914
  • Fax: 713-529-1967
Mailing address:
  • Phone: 713-529-1914
  • Fax: 713-529-1967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberE6345
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberE6345
License Number StateTX

VIII. Authorized Official

Name: DR. ROBERT W. FAYLE
Title or Position: OWNER
Credential: M.D.
Phone: 713-529-1914