MEDICARE: EMERARDO FALCON JR., M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	G3343	TX

General Provider Information

NPI Number	:	1003819541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMERARDO FALCON JR., M.D., P.A.

Provider Business Mailing Address
First Line	:	100B MEDICAL DR
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5674
Country	:	US
Telephone Number	:	979-297-6401
Fax Number	:	979-297-6809

Provider Business Practice Location Address
First Line	:	100B MEDICAL DR
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5674
Country	:	US
Telephone Number	:	979-297-6401
Fax Number	:	979-297-6809

Authorized Official
Title or Position	:	OWNER
Name	:	EMERARDO FALCON JR.
Credential	:	M.D.
Telephone Number	:	979-297-6401

Provider Enumeration Date	:	05/29/2005
Last Update Date	:	07/03/2014

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