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General NPI Number Information
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NPI Number | 1841220852
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Entity Type | Individual
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Provider Name | SAMER C FAYSAL FNP
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 117 VISION PARK BLVD
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City | SHENANDOAH
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State | TX
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Zip | 77384
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Country | US
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Telephone | 936-443-8460
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Fax | 866-936-4875
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Provider Business Mailing Address
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Address Line | 33615 WINDCREST ESTATES BLVD
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City | MAGNOLIA
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State | TX
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Zip | 77354-4726
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Country | US
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Telephone | 936-756-1651
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Fax | 866-936-4875
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | TX8953
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 798026
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License Number State | TX
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