Healthcare Provider Details

I. General information

NPI: 1558817791
Provider Name (Legal Business Name): FRANKENFELD HOME VISITS MHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4816 AURORA AVENUE N
SEATTLE WA
98103
US

IV. Provider business mailing address

1575 HERITAGE DR SUITE 205
MCKINNEY TX
75069
US

V. Phone/Fax

Practice location:
  • Phone: 844-633-4663
  • Fax:
Mailing address:
  • Phone: 469-307-5822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY PINCKNEY
Title or Position: VP OF PAYER RELATIONS
Credential:
Phone: 469-307-5822