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General NPI Number Information
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NPI Number | 1629029244
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Entity Type | Organization
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Legal Business Name | GO-FAITH MEDICAL SERVICES, INC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 12315 W BELLFORT ST
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City | STAFFORD
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State | TX
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Zip | 77477-1312
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Country | US
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Telephone | 713-774-9003
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Fax | 713-774-9000
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Provider Business Mailing Address
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Address Line | 12315 W BELLFORT ST
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City | STAFFORD
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State | TX
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Zip | 77477-1312
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Country | US
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Telephone | 713-774-9003
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Fax | 713-774-9000
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PATRICK O IVBIEVBIOKUN
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Credential |
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Telephone | 713-774-9003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010596
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License Number State | TX
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