Provider Demographics
NPI:1295246833
Name:ANGELA M FROST
Entity type:Organization
Organization Name:ANGELA M FROST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-524-4214
Mailing Address - Street 1:8540 BROADWAY S
Mailing Address - Street 2:STE 2000
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8540 BROADWAY S
Practice Address - Street 2:STE 2000
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:832-524-4214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX282641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043568603OtherNPI TYPE 1