Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MT203433 | DC |
NPI | 1003251984 |
---|---|
Provider Name | Samuel Christopher Faith |
First Address | El Paso, TX 79907-1405 |
Second Address | El Paso, TX 79907-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2013 |
Last Update Date | 26/12/2019 |