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General NPI Number Information
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NPI Number | 1770588386
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Entity Type | Individual
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Provider Name | ROGER A FROST CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 803 W LAMPASAS ST
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City | ENNIS
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State | TX
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Zip | 75119-4535
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Country | US
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Telephone | 972-875-0900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 388
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City | NEWTON
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State | KS
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Zip | 67114-0388
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Country | US
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Telephone | 316-281-3700
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Fax | 316-282-4322
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 701787
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License Number State | TX
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