Organization
GO-FAITH MEDICAL SERVICES, INC
Active
Other names
Faith Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK O IVBIEVBIOKUN (ADMINISTRATOR)
(713) 774-9003
Entity
Organization
Contact information
Practice address
12315 W BELLFORT ST, STAFFORD, TX 77477-1312
(713) 774-9003
(713) 774-9000
Mailing address
12315 W BELLFORT ST, STAFFORD, TX 77477-1312
(713) 774-9003
(713) 774-9000
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
010596
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
673163
MEDICARE PTAN
—
Enumeration date
05/16/2006
Last updated
12/07/2016
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