Provider Demographics
NPI: | 1831647734 |
---|---|
Name: | FRISCO NEURO COLLABORATIONS, PLLC |
Entity Type: | Organization |
Organization Name: | FRISCO NEURO COLLABORATIONS, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR OF CLIENT EXPERIENCE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROXANNA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LAROQUE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 210-598-4262 |
Mailing Address - Street 1: | 1141 N LOOP 1604 E #105-612 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN ANTONIO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78232 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 210-598-4262 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9 MEDICAL PKWY SUITE 108 |
Practice Address - Street 2: | |
Practice Address - City: | FARMERS BRANCH |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75234 |
Practice Address - Country: | US |
Practice Address - Phone: | 210-598-4262 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-09-20 |
Last Update Date: | 2022-07-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |