Provider Demographics
NPI:1558920082
Name:MEDCO ER FRISCO LLC
Entity Type:Organization
Organization Name:MEDCO ER FRISCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAEID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-392-4100
Mailing Address - Street 1:PO BOX 232398
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92023-2398
Mailing Address - Country:US
Mailing Address - Phone:469-392-4100
Mailing Address - Fax:469-840-4608
Practice Address - Street 1:5600 ELDORADO PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3207
Practice Address - Country:US
Practice Address - Phone:469-840-4608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-09
Last Update Date:2019-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care