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General NPI Number Information
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NPI Number | 1699003665
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Entity Type | Organization
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Legal Business Name | FAITH FAMILY MEDICAL CENTER
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 309 NORTH MAIN STREET
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City | STRATFORD
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State | TX
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Zip | 79084-0126
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Country | US
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Telephone | 806-396-4846
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Fax | 806-396-4870
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Provider Business Mailing Address
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Address Line | 309 NORTH MAIN STREET PO BOX 126
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City | STRATFORD
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State | TX
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Zip | 79084-0126
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Country | US
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Telephone | 806-396-4846
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Fax | 806-396-4870
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MARIA LOUISA ORTEGA
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Credential |
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Telephone | 806-396-4846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 739475
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License Number State | TX
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