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NPI Code Detail

MEDICARE: FAAC, PA

MEDICARE: FAAC, PA
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
1207KA0200XAllergy PhysicianH4184TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10016CVOTHERTXBCBS
25002043OTHERTXAETNA

General Provider Information

NPI Number : 1730290099
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAAC, PA
Provider Business Mailing Address
First Line : 3051 CHURCHILL DR STE 130
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-2710
Country : US
Telephone Number : 972-539-0086
Fax Number : 972-355-9680
Provider Business Practice Location Address
First Line : 3051 CHURCHILL DR STE 130
Second Line :
City : FLOWER MOUND
State : TX
Zip : 75022-2710
Country : US
Telephone Number : 972-539-0086
Fax Number : 972-355-9680
Authorized Official
Title or Position : SPECIALTY INSURANCE MANAGER
Name : TAMMY SHEREN
Credential :
Telephone Number : 972-539-0086
Provider Enumeration Date : 08/31/2006
Last Update Date : 01/16/2026

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Directions to “FAAC, PA ” Practice Location

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