Individual provider Active NPI

Fauniel Alicia Self, MD

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1245812486
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
U8434 Issued in TX
Practice address
6431 Fannin St Ste JJL 2706
Houston, TX 77030-1501
Phone
(713) 500-0758
NPI assigned
Apr 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X U8434 TX Primary

Addresses

Primary practice location

6431 Fannin St Ste JJL 2706
Houston, TX 77030-1501

Mailing address

6431 Fannin St Ste JJL 2706
Houston, TX 77030-1501
Phone (713) 500-0758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426000994 TX Practitioner - Emergency Medicine 4385084169 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brazos Valley Emergency Physicians PA Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Memorial Hermann Hospital Based Physician Group Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients
Bryan Emergency Physicians PA Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince Jan 6, 2025 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Apr 18, 2024 Accepting new patients

Locations

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

18220 State Highway 249
Ste 475
Houston, TX 77070
Phone (832) 698-5511

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

929 Gessner Rd
Houston, TX 77024
Phone (713) 242-3650

921 Gessner Rd
Houston, TX 77024
Phone (713) 242-3439

18220 Tomball Pkwy
Houston, TX 77070
Phone (281) 477-0000

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

2555 Gulf Fwy S
#C1100
League City, TX 77573

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

210 S Judson St
Navasota, TX 77868
Phone (936) 825-6585

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

9250 Pinecroft Dr
#C
Shenandoah, TX 77380

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1245812486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST STE JJL 2706",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST STE JJL 2706",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "FAUNIEL",
        "middle_name": "ALICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-27",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U8434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.