Provider Demographics
NPI:1770207599
Name:FAITH AMBULATORY SURGERY CENTER
Entity type:Organization
Organization Name:FAITH AMBULATORY SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-999-1659
Mailing Address - Street 1:8616 GREENVILLE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7166
Mailing Address - Country:US
Mailing Address - Phone:972-999-1659
Mailing Address - Fax:972-805-2777
Practice Address - Street 1:8616 GREENVILLE AVE STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7166
Practice Address - Country:US
Practice Address - Phone:972-999-1659
Practice Address - Fax:972-805-2777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-27
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical