Provider Demographics
NPI:1023318169
Name:GOOD FAITH MEDICAL, PA
Entity type:Organization
Organization Name:GOOD FAITH MEDICAL, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:TAMAYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-710-0786
Mailing Address - Street 1:302 W RHAPSODY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3108
Mailing Address - Country:US
Mailing Address - Phone:210-521-6328
Mailing Address - Fax:210-521-6329
Practice Address - Street 1:302 W RHAPSODY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3108
Practice Address - Country:US
Practice Address - Phone:210-521-6328
Practice Address - Fax:210-521-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty