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General NPI Number Information
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NPI Number | 1043706831
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Entity Type | Organization
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Legal Business Name | TEXAN FROGS PLLC
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 502 N CARROLL AVE STE 130
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6449
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Country | US
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Telephone | 972-638-0994
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Fax |
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Provider Business Mailing Address
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Address Line | 502 N CARROLL AVE STE 130
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6449
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Country | US
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Telephone | 972-638-0994
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. THOMAS JOSEPH KRAMER
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Credential | DC
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Telephone | 972-638-0994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13148
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License Number State | TX
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