Individual
DR. TARRA FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-1455
Mailing address
101 BODIN CIR, 60 MDOS SGOMK/NEPHROLOGY, TRAVIS AFB, CA 94535-1809
(707) 816-5930
(707) 816-5665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
67125
GA
207RN0300X
Nephrology Physician
Primary
67125
GA
Other
Enumeration date
07/20/2010
Last updated
05/11/2023
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