Provider Demographics
NPI:1508897166
Name:FAITH HEALTHCARE SERVICES,INC
Entity Type:Organization
Organization Name:FAITH HEALTHCARE SERVICES,INC
Other - Org Name:FE FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:U
Authorized Official - Last Name:EROMOSELE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:956-581-0401
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0057
Mailing Address - Country:US
Mailing Address - Phone:956-581-0401
Mailing Address - Fax:956-581-0654
Practice Address - Street 1:2901 LA HOMA BLVD
Practice Address - Street 2:STE B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-581-0401
Practice Address - Fax:956-581-0654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02395363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty