Provider Demographics
NPI:1427486711
Name:SAA, FAUSTO (FNP,BC)
Entity type:Individual
Prefix:MR
First Name:FAUSTO
Middle Name:
Last Name:SAA
Suffix:
Gender:M
Credentials:FNP,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21903 ROAN BLF
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2740
Mailing Address - Country:US
Mailing Address - Phone:305-335-6542
Mailing Address - Fax:
Practice Address - Street 1:2827 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4813
Practice Address - Country:US
Practice Address - Phone:305-335-6542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX735351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily