Individual
MICHAEL BROUSE FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6411 FANNIN ST, 1 JONES SUITE 400, HOUSTON, TX 77030-1501
(713) 704-6800
(713) 704-6616
Mailing address
6431 FANNIN ST, MSB 4.234, HOUSTON, TX 77030-1501
(713) 500-6671
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
18655
AL
207RG0100X
Gastroenterology Physician
Primary
N1316
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000025081
—
AL
05
—
0122311
—
MS
01
—
051025081
BLUE CROSS
AL
05
—
198331401
—
TX
01
—
8F6668
BCBS
TX
Enumeration date
10/04/2006
Last updated
01/18/2011
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