| Organization Name: | FAITH SURGICAL CENTER, LLC |
| NPI Number: | 1386032860 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOUGLAS A GATEWOOD (OWNER) |
| Mailing Address: | 3716 Standridge Dr Ste 100 The Colony |
| State: | TX US |
| Postal Code: | 750564146 |
| Phone Number: | 9723707200 |
| Fax Number: | 9723707208 |
| NPI Enumeration Date: | 01/06/2015 |
| NPI Last Update Date: | 01/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 130098 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |