Provider Demographics
NPI:1235905605
Name:FRONTIER INFUSION CENTER RP LLC
Entity Type:Organization
Organization Name:FRONTIER INFUSION CENTER RP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY-MILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-539-9428
Mailing Address - Street 1:30 N GOULD ST STE 26576
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-6317
Mailing Address - Country:US
Mailing Address - Phone:212-518-3755
Mailing Address - Fax:
Practice Address - Street 1:6611 RIVER PLACE BLVD STE 305
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-1163
Practice Address - Country:US
Practice Address - Phone:713-882-8617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care