Provider Demographics
NPI:1114223070
Name:FRISBIE, PENNIRAE HUNT (PA)
Entity Type:Individual
Prefix:
First Name:PENNIRAE
Middle Name:HUNT
Last Name:FRISBIE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1616 FM 685
Mailing Address - Street 2:106
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7536
Mailing Address - Country:US
Mailing Address - Phone:210-323-7464
Mailing Address - Fax:512-334-2321
Practice Address - Street 1:1616 FM 685
Practice Address - Street 2:106
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7536
Practice Address - Country:US
Practice Address - Phone:512-252-9094
Practice Address - Fax:512-252-9095
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA05022363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant