MEDICARE: MR. MICHAEL WARREN FAUST FNP-BC

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	363LF0000X	Family Nurse Practitioner	1099292	TX

General Provider Information

NPI Number	:	1164132783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL WARREN FAUST FNP-BC

Provider Business Mailing Address
First Line	:	155 E SONTERRA BLVD STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3988
Country	:	US
Telephone Number	:	210-474-0530
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 E SONTERRA BLVD STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3988
Country	:	US
Telephone Number	:	210-474-0530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	03/30/2023

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