Individual provider Active NPI

Robert Yates Faseler, D.O.

  • Family Medicine Physician
  • Port Neches, TX
National Provider Identifier
1871592006
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0337 Issued in TX
Practice address
882 Sierra Dr
Port Neches, TX 77651-5607
Phone
(409) 722-1234
Fax
(409) 722-3270
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0337 TX Primary

Addresses

Primary practice location

882 Sierra Dr
Port Neches, TX 77651-5607

Mailing address

882 Sierra Dr
Port Neches, TX 77651-5607
Phone (409) 722-1234

Other identifiers 1

IdentifierTypeStateIssuer
131989905MedicaidTX

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)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-County Family Care PLLC CurrentSince Aug 1, 2015 Accepting new patients
Houston Neurological Institute LLP PastSince Apr 1, 2015 Accepting new patients

Locations

882 Sierra Dr
Port Neches, TX 77651
Phone (409) 722-1234

Organizations & group practices 2

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1871592006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 SIERRA DR",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776515607",
            "telephone_number": "409-722-1234",
            "fax_number": "409-722-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 SIERRA DR",
            "city": "PORT NECHES",
            "state": "TX",
            "postal_code": "776515607",
            "telephone_number": "409-722-1234",
            "fax_number": "409-722-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASELER",
        "first_name": "ROBERT",
        "middle_name": "YATES",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H0337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131989905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Neches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.