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General NPI Number Information
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NPI Number | 1447695762
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Entity Type | Organization
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Legal Business Name | FAITH FAMILY CLINIC
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 700 S ZARZAMORA ST SUITE LL1
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City | SAN ANTONIO
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State | TX
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Zip | 78207-5255
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Country | US
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Telephone | 210-653-1511
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Fax | 210-653-9141
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Provider Business Mailing Address
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Address Line | 8711 VILLAGE DR SUITE 305
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5418
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Country | US
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Telephone | 210-653-1511
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Fax | 210-653-9141
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES A YOUNG
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Credential |
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Telephone | 210-653-1511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | TX
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