MEDICARE: FRISCO SPINE, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician
2	2084N0400X	Neurology Physician
3	2084N0600X	Clinical Neurophysiology Physician
4	207T00000X	Neurological Surgery Physician	TX

General Provider Information

NPI Number	:	1700014826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRISCO SPINE, PA

Provider Business Mailing Address
First Line	:	PO BOX 6020
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-0225
Country	:	US
Telephone Number	:	214-506-2610
Fax Number	:	972-681-8727

Provider Business Practice Location Address
First Line	:	8350 DALLAS PKWY STE 300
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-5076
Country	:	US
Telephone Number	:	972-377-9200
Fax Number	:	972-377-9300

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	BRISSA PALACIOS
Credential	:
Telephone Number	:	469-294-8926

Provider Enumeration Date	:	06/26/2009
Last Update Date	:	05/19/2020

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Directions to “FRISCO SPINE, PA ” Practice Location

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