Provider Demographics
NPI:1346469921
Name:STONEBRIAR FAMILY PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:STONEBRIAR FAMILY PHYSICIANS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOYD
Authorized Official - Middle Name:R
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-712-6690
Mailing Address - Street 1:PO BOX 2758
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0051
Mailing Address - Country:US
Mailing Address - Phone:972-712-6690
Mailing Address - Fax:972-712-7190
Practice Address - Street 1:4500 HILLCREST RD STE 180
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5420
Practice Address - Country:US
Practice Address - Phone:972-712-6690
Practice Address - Fax:972-712-7190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00542TMedicare ID - Type UnspecifiedPROVIDER NUMBER