Provider Demographics
NPI:1497398341
Name:FRISBY, ELIZABETH TANN (BA, MED, EDD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:TANN
Last Name:FRISBY
Suffix:
Gender:F
Credentials:BA, MED, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1012
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757-1012
Mailing Address - Country:US
Mailing Address - Phone:903-724-5425
Mailing Address - Fax:
Practice Address - Street 1:11646 FM 855 W
Practice Address - Street 2:
Practice Address - City:BULLARD
Practice Address - State:TX
Practice Address - Zip Code:75757-9101
Practice Address - Country:US
Practice Address - Phone:903-724-5425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15195101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional