Provider Demographics
NPI:1003251984
Name:FAITH, SAMUEL CHRISTOPHER (MD MPH)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:CHRISTOPHER
Last Name:FAITH
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 LOMALAND DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-1405
Mailing Address - Country:US
Mailing Address - Phone:915-591-4441
Mailing Address - Fax:
Practice Address - Street 1:1240 LOMALAND DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-1405
Practice Address - Country:US
Practice Address - Phone:915-591-4441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
281P00000X, 282NC0060X
DCMT203433207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No281P00000XHospitalsChronic Disease Hospital
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access