Active NPI
Matthew Faubion, MD
- Psychiatry Physician
- Dallas, TX
National Provider Identifier
1689230138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- BP10066890
- Practice address
- 2816 Vine St Apt 262
Dallas, TX 75204-4088 - Phone
- (501) 837-6692
- NPI assigned
- May 9, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | BP10066890 | TX | Primary |
Addresses
Primary practice location
2816 Vine St Apt 262
Dallas, TX 75204-4088
Mailing address
2816 Vine St Apt 262
Dallas, TX 75204-4088
Phone (501) 837-6692
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 693531 | Other | TX | TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING ID NUMBER |
| BP10066890 | Other | TX | TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING PERMIT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10066890 | TX | MD | Psychiatry Physician |
Interoperability endpoints
- mfaubion91388@direct.phhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1689230138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2816 VINE ST APT 262",
"city": "DALLAS",
"state": "TX",
"postal_code": "752044088",
"telephone_number": "501-837-6692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2816 VINE ST APT 262",
"city": "DALLAS",
"state": "TX",
"postal_code": "752044088",
"telephone_number": "501-837-6692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAUBION",
"first_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-09",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "BP10066890",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING ID NUMBER",
"identifier": "693531",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS MEDICAL BOARD PHYSICIAN IN TRAINING PERMIT",
"identifier": "BP10066890",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.