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General NPI Number Information
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NPI Number | 1558651059
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Entity Type | Organization
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Legal Business Name | THE AC ENDOSCOPY GROUP PA
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Dates
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Enumeration Date | 04/18/2011
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 2215 CEDAR SPRINGS RD APT 309
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City | DALLAS
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State | TX
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Zip | 75201
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Country | US
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Telephone | 210-573-7869
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Fax | 469-364-3756
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Provider Business Mailing Address
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Address Line | 2215 CEDAR SPRINGS RD APT 309
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City | DALLAS
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State | TX
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Zip | 75201
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Country | US
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Telephone | 210-573-7869
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Fax | 469-364-3756
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. CLAYTON FRENZEL
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Credential | D.O.
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Telephone | 210-573-7869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 045212
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License Number State | TX
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