Provider Demographics
NPI:1477290294
Name:CFMA DENTON PLLC
Entity Type:Organization
Organization Name:CFMA DENTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FROSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-240-8861
Mailing Address - Street 1:251 E SOUTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6269
Mailing Address - Country:US
Mailing Address - Phone:817-240-8861
Mailing Address - Fax:
Practice Address - Street 1:3105 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6893
Practice Address - Country:US
Practice Address - Phone:940-383-3444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty