Provider Demographics
NPI:1013976190
Name:HEALTHCARE ASSOCIATES OF FRISCO PA
Entity Type:Organization
Organization Name:HEALTHCARE ASSOCIATES OF FRISCO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:GAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-258-7499
Mailing Address - Street 1:PO BOX 678355
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8355
Mailing Address - Country:US
Mailing Address - Phone:214-297-3000
Mailing Address - Fax:214-297-3006
Practice Address - Street 1:4500 HILLCREST ROAD
Practice Address - Street 2:SUITE 1200
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:214-297-3000
Practice Address - Fax:214-297-3006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00562UMedicare ID - Type Unspecified