Provider Demographics
NPI:1811705148
Name:FRONTIER DIRECT CARE LEANDER
Entity type:Organization
Organization Name:FRONTIER DIRECT CARE LEANDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZZOPINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-545-5224
Mailing Address - Street 1:119 W VAN BUREN AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-6414
Mailing Address - Country:US
Mailing Address - Phone:956-983-9272
Mailing Address - Fax:956-275-2000
Practice Address - Street 1:11840 HERO WAY W STE 200
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3347
Practice Address - Country:US
Practice Address - Phone:956-983-9271
Practice Address - Fax:737-201-2705
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRONTIER HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty