Provider Demographics
NPI:1679658249
Name:FROSTVIEW LANE, LLC
Entity Type:Organization
Organization Name:FROSTVIEW LANE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-271-7777
Mailing Address - Street 1:11727 S SAM HOUSTON PKWY W STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2343
Mailing Address - Country:US
Mailing Address - Phone:713-271-7777
Mailing Address - Fax:713-271-8585
Practice Address - Street 1:11727 S SAM HOUSTON PKWY W STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2343
Practice Address - Country:US
Practice Address - Phone:713-271-7777
Practice Address - Fax:713-271-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118281315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities