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General NPI Number Information
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NPI Number | 1407409311
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Entity Type | Organization
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Legal Business Name | CONNECTIONS PRIMARY CARE FRISCO
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 255 W LEBANON STE 124
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City | FRISCO
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State | TX
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Zip | 75036-3412
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Country | US
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Telephone | 469-222-3152
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 SHORELINE DR STE 151
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City | DENTON
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State | TX
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Zip | 76210-0176
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Country | US
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Telephone | 469-222-3152
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LANDON AWSTIN GREGG
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Credential | LCSW, LCDC
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Telephone | 469-222-3152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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