Individual
DR. PETER MICHAEL FAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D., M.B.A.
Contact information
Practice address
1509B W 18TH ST, HOUSTON, TX 77008-1533
(832) 618-1010
(832) 838-4232
Mailing address
1509B W 18TH ST, HOUSTON, TX 77008-1533
(832) 618-1010
(832) 838-4232
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
51161
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036847402
—
TX
01
—
11317745
CAQH
TX
01
—
531239
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/19/2007
Last updated
05/12/2008
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