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Individual

DR. FRANK JOSEPH FASULLO JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
17047 EL CAMINO REAL, SUITE 105, HOUSTON, TX 77058-2652
(281) 415-1972
(281) 486-9904
Mailing address
17047 EL CAMINO REAL, SUITE 105, HOUSTON, TX 77058-2652
(281) 415-1972
(281) 486-9904

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
J8532
TX
207Q00000X
Family Medicine Physician
Primary
J8532
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
140050914
TX
Enumeration date
12/17/2005
Last updated
12/21/2021
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