Healthcare Provider Details

I. General information

NPI: 1407597461
Provider Name (Legal Business Name): ROBERT SEAN FARIES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 03/30/2025
Certification Date: 03/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 FANNIN ST
HOUSTON TX
77030-3000
US

IV. Provider business mailing address

6431 FANNIN MSB 3.151
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-5800
  • Fax: 713-500-5805
Mailing address:
  • Phone: 713-500-5800
  • Fax: 713-500-5805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV6298
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: