Provider Demographics
NPI:1649703224
Name:FRONTIER ACO LLC
Entity type:Organization
Organization Name:FRONTIER ACO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAC
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-814-2172
Mailing Address - Street 1:8278 BELLAIRE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4090
Mailing Address - Country:US
Mailing Address - Phone:713-272-8858
Mailing Address - Fax:
Practice Address - Street 1:8278 BELLAIRE BLVD
Practice Address - Street 2:STE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4090
Practice Address - Country:US
Practice Address - Phone:713-272-8858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6791302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization