Provider Demographics
NPI:1033985809
Name:FRONTIER DIRECT CARE BROWNSVILLE SOUTH
Entity Type:Organization
Organization Name:FRONTIER DIRECT CARE BROWNSVILLE SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICE
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZZOPINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-545-5224
Mailing Address - Street 1:119 W VAN BUREN AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6400
Mailing Address - Country:US
Mailing Address - Phone:956-983-9272
Mailing Address - Fax:956-265-1284
Practice Address - Street 1:222 N. EXPRESSWAY 77
Practice Address - Street 2:SUITE 302
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521
Practice Address - Country:US
Practice Address - Phone:956-303-8995
Practice Address - Fax:956-265-1053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRONTIER STAFFING PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty