Provider Demographics
NPI:1164703815
Name:FAITH SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:FAITH SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-851-0801
Mailing Address - Street 1:3716 STANDRIDGE DR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4146
Mailing Address - Country:US
Mailing Address - Phone:214-436-8000
Mailing Address - Fax:214-436-8005
Practice Address - Street 1:3716 STANDRIDGE DR
Practice Address - Street 2:SUITE #100
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-4146
Practice Address - Country:US
Practice Address - Phone:214-436-8000
Practice Address - Fax:214-436-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPENDING261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical