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General NPI Number Information
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NPI Number | 1750199006
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Entity Type | Organization
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Legal Business Name | FRONTIER DIRECT CARE - DALLAS
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 8240 MOBERLY LN
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City | DALLAS
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State | TX
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Zip | 75227-2043
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Country | US
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Telephone | 945-212-2370
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Fax | 945-202-3743
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Provider Business Mailing Address
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Address Line | 119 W VAN BUREN AVE STE 10
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City | HARLINGEN
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State | TX
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Zip | 78550-6414
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Country | US
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Telephone | 945-212-2370
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Fax | 945-202-3743
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Authorized Official
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Title or Position | HEAD OF OPERATIONS
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Name | VANESSA RAMIREZ
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Credential |
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Telephone | 325-212-4207
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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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