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NPI 1598927543

NPI 1598927543 : ANDREW JEB FROST D O : DOUGLASSVILLE, TX

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General NPI Number Information
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    NPI Number           |    1598927543
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW JEB FROST D O
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/01/2008
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    Last Update Date     |    10/25/2012
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Provider Practice Location Address
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    Address Line         |    821 COUNTY ROAD 2466 
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    City                 |    DOUGLASSVILLE
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    State                |    TX
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    Zip                  |    75560-7211
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    Country              |    US
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    Telephone            |    903-278-9891
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    821 COUNTY ROAD 2466 
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    City                 |    DOUGLASSVILLE
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    State                |    TX
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    Zip                  |    75560-7211
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    Country              |    US
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    Telephone            |    903-278-9891
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    N-7540
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    License Number State |    TX
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