MEDICARE: MRS. YOLANDA MARIE FRONTINO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	2026938	TX

General Provider Information

NPI Number	:	1467932137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YOLANDA MARIE FRONTINO

Provider Business Mailing Address
First Line	:	8001 WESTERN HILLS BLVD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76108-3524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8001 WESTERN HILLS BLVD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76108-3524
Country	:	US
Telephone Number	:	817-246-4953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2018
Last Update Date	:	08/21/2018

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