Provider Demographics
NPI:1831647734
Name:FRISCO NEURO COLLABORATIONS, PLLC
Entity type:Organization
Organization Name:FRISCO NEURO COLLABORATIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT EXPERIENCE
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-598-4262
Mailing Address - Street 1:1141 N LOOP 1604 E #105-612
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:210-598-4262
Mailing Address - Fax:
Practice Address - Street 1:9 MEDICAL PKWY SUITE 108
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234
Practice Address - Country:US
Practice Address - Phone:210-598-4262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty