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General NPI Number Information
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NPI Number | 1366880080
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Entity Type | Organization
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Legal Business Name | FRISCO ENT FOR CHILDREN, P.L.L.C.
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 11445 DALLAS PKWY SUITE 240
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City | FRISCO
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State | TX
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Zip | 75033-4255
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Country | US
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Telephone | 972-315-2005
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Fax |
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Provider Business Mailing Address
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Address Line | 783 N DENTON TAP RD SUITE 200
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City | COPPELL
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State | TX
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Zip | 75019-2169
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Country | US
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Telephone | 972-745-8400
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DIANNA J MOORE
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Credential | CMPE
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Telephone | 972-745-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YP0228X
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Taxonomy Name | Pediatric Otolaryngology Physician
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License Number |
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License Number State |
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