Provider Demographics
NPI:1407328321
Name:SOH OF TEXAS SAMSON LIU PLLC
Entity Type:Organization
Organization Name:SOH OF TEXAS SAMSON LIU PLLC
Other - Org Name:FRISCO DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNSHINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-753-8154
Mailing Address - Street 1:8715 LEBANON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8715 LEBANON RD STE 300
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-8653
Practice Address - Country:US
Practice Address - Phone:972-335-2201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOH OF TEXAS SAMSON LIU PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-18
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty