Provider Demographics
NPI:1366880080
Name:FRISCO ENT FOR CHILDREN, P.L.L.C.
Entity type:Organization
Organization Name:FRISCO ENT FOR CHILDREN, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE
Authorized Official - Phone:972-745-8400
Mailing Address - Street 1:783 N DENTON TAP RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2169
Mailing Address - Country:US
Mailing Address - Phone:972-745-8400
Mailing Address - Fax:
Practice Address - Street 1:11445 DALLAS PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4255
Practice Address - Country:US
Practice Address - Phone:972-315-2005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Single Specialty