Provider Demographics
NPI:1841407012
Name:FRISCO FAMILY CLINIC PA
Entity Type:Organization
Organization Name:FRISCO FAMILY CLINIC PA
Other - Org Name:ALLEN CHILDRENS CLINIC PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TALUKDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-359-0000
Mailing Address - Street 1:4461 COIT RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0521
Mailing Address - Country:US
Mailing Address - Phone:972-335-3300
Mailing Address - Fax:214-387-4518
Practice Address - Street 1:600 W MCDERMOTT DR
Practice Address - Street 2:SUITE B
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2704
Practice Address - Country:US
Practice Address - Phone:972-359-0000
Practice Address - Fax:972-359-1000
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-17
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty