Provider Demographics
NPI:1295324218
Name:FRISCO ER FACILITY LLC
Entity type:Organization
Organization Name:FRISCO ER FACILITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-772-6754
Mailing Address - Street 1:PO BOX 2586
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2856
Mailing Address - Country:US
Mailing Address - Phone:214-390-7697
Mailing Address - Fax:972-432-6692
Practice Address - Street 1:12600 ROLATER RD # 100
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5188
Practice Address - Country:US
Practice Address - Phone:214-810-2902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care