Provider Demographics
NPI:1568977700
Name:FRONTERA THERAPY, PLLC
Entity Type:Organization
Organization Name:FRONTERA THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WEYLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURLINGAME
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSW, LCSW
Authorized Official - Phone:915-216-2978
Mailing Address - Street 1:7220 ROCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1522
Mailing Address - Country:US
Mailing Address - Phone:915-216-2978
Mailing Address - Fax:915-218-6121
Practice Address - Street 1:154 N FESTIVAL DR STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6265
Practice Address - Country:US
Practice Address - Phone:915-216-2978
Practice Address - Fax:915-218-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty