| Texas Faith Llc | |
|
1015 Gibbins Rd Ste A Arlington TX 76011-5615 | |
| (972) 734-5400 | |
| (972) 734-5433 |
| Full Name | Texas Faith Llc |
|---|---|
| Speciality | General Practice |
| Location | 1015 Gibbins Rd Ste A, Arlington, Texas |
| Authorized Official Name and Position | Kathiravan Manthiram (CEO) |
| Authorized Official Contact | 9727345400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Faith Llc 1015 Gibbins Rd Ste A Arlington TX 76011-5615 Ph: (972) 734-5400 | Texas Faith Llc 1015 Gibbins Rd Ste A Arlington TX 76011-5615 Ph: (972) 734-5400 |
| NPI Number | 1174191902 |
|---|---|
| Provider Enumeration Date | 06/17/2021 |
| Last Update Date | 06/17/2021 |
| Medicare PECOS PAC ID | 9032512900 |
|---|---|
| Medicare Enrollment ID | O20210729002267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174191902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Gary Alan Debakey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770663254 PECOS PAC ID: 7113900747 Enrollment ID: I20040617001750 |
| Provider Name | Federico P Ilang Ilang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417985300 PECOS PAC ID: 1951371160 Enrollment ID: I20040727000517 |
| Provider Name | Fe Queniahan Gonzaga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013971597 PECOS PAC ID: 0042513897 Enrollment ID: I20160215002399 |
| Provider Name | Gregory Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922147933 PECOS PAC ID: 9739337395 Enrollment ID: I20160323002289 |
| Provider Name | Thadeus J Schulz |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1407983117 PECOS PAC ID: 7618219007 Enrollment ID: I20190506001061 |
| Provider Name | Holly Canaday |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255879581 PECOS PAC ID: 1658657044 Enrollment ID: I20210719000118 |
| Provider Name | Mary Mckinley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023003993 PECOS PAC ID: 0446163240 Enrollment ID: I20211022000447 |
| Provider Name | Nida Fatima |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1982352175 PECOS PAC ID: 4587036421 Enrollment ID: I20230202001273 |
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