Provider Demographics
NPI:1215299045
Name:FAIN, MICHAEL E
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:FAIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4543 POST OAK PLACE DR
Mailing Address - Street 2:SUITE 125
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3160
Mailing Address - Country:US
Mailing Address - Phone:713-862-4443
Mailing Address - Fax:832-369-7301
Practice Address - Street 1:1550 HAWKINS BLVD
Practice Address - Street 2:SUITE 19
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-2650
Practice Address - Country:US
Practice Address - Phone:915-633-9099
Practice Address - Fax:915-633-8290
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80240237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist