=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114550621
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALICIA INEZ FAULKNER NP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2020
-----------------------------------------------------
Last Update Date | 06/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9645 BARKER CYPRESS RD STE 100
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77433-5292
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 346-250-6010
-----------------------------------------------------
Fax | 346-200-3572
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5907 RANCH RIATA CT
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77449-2047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-508-2387
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 811894
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 33490
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------