Provider Demographics
NPI:1487068060
Name:FIALLO, FRANCISCO (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:
Last Name:FIALLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 PERRYTON PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2817
Mailing Address - Country:US
Mailing Address - Phone:806-665-0801
Mailing Address - Fax:806-665-8503
Practice Address - Street 1:3023 PERRYTON PKWY STE 201
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-2817
Practice Address - Country:US
Practice Address - Phone:806-663-5671
Practice Address - Fax:806-665-8503
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0393207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386562801Medicaid