Individual
MATTHEW FAUBION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2816 VINE ST APT 262, DALLAS, TX 75204-4088
(501) 837-6692
Mailing address
2816 VINE ST APT 262, DALLAS, TX 75204-4088
(501) 837-6692
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
BP10066890
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
693531
TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING ID NUMBER
TX
01
—
BP10066890
TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING PERMIT
TX
Enumeration date
05/09/2019
Last updated
05/09/2019
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