Healthcare Provider Details

I. General information

NPI: 1730453408
Provider Name (Legal Business Name): ASCENSION CAMG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2012
Last Update Date: 02/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6351 PRESTON RD SUITE 160
FRISCO TX
75034-5805
US

IV. Provider business mailing address

6351 PRESTON RD SUITE 160
FRISCO TX
75034-5805
US

V. Phone/Fax

Practice location:
  • Phone: 214-872-3381
  • Fax: 214-872-3387
Mailing address:
  • Phone: 214-872-3381
  • Fax: 214-872-3387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ERIC SNOWDEN
Title or Position: MANAGING PARTNER
Credential: D.C.
Phone: 214-872-3381