Provider Demographics
NPI:1881322469
Name:FRISCO EMERGENCY ROOM LLC
Entity type:Organization
Organization Name:FRISCO EMERGENCY ROOM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
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:469-257-3500
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:469-482-0861
Mailing Address - Fax:469-273-1720
Practice Address - Street 1:12600 ROLATER RD
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:469-200-5222
Practice Address - Fax:469-200-5320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty