Basic Information
| Provider Information | |||||||||
| NPI: | 1093185944 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRISCO CENTER FOR INTERNAL MEDICINE, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9330 LBJ FWY STE 800 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752434310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727925700 | ||||||||
| FaxNumber: | 2145061170 | ||||||||
| Practice Location | |||||||||
| Address1: | 12500 LEBANON RD STE 103 | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750359474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142970297 | ||||||||
| FaxNumber: | 2142970298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2015 | ||||||||
| LastUpdateDate: | 10/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | SHAH | ||||||||
| AuthorizedOfficialFirstName: | NEELA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD, OWNER, PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 2142970297 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 10/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | M2801 | 01 | TX | 207R00000X | OTHER | M6630 | 01 | TX | 207R00000X | OTHER |