Basic Information
| Provider Information | |||||||||
| NPI: | 1104381292 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEXAS HEALTH HOSPITAL FRISCO | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 734468 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753734468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8008906034 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12400 DALLAS PKWY | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750334224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694952000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2019 | ||||||||
| LastUpdateDate: | 04/22/2022 | ||||||||
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| AuthorizedOfficialLastName: | MINCHER | ||||||||
| AuthorizedOfficialFirstName: | JEFF | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VP REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 6822363013 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 670260 | 01 | TX | MEDICARE | OTHER | HOHH278D01 | 01 | TX | BCBS | OTHER |