Basic Information
| Provider Information | |||||||||
| NPI: | 1619563277 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WRFER DENTON, LLC | ||||||||
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| OtherOrganizationName: | TOTAL CARE DENTON | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 960 RIDGEVIEW DR | ||||||||
| Address2: | STE 140 PMB 237 | ||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143907697 | ||||||||
| FaxNumber: | 9724326692 | ||||||||
| Practice Location | |||||||||
| Address1: | 3111 TEASLEY LN | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762058025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4695899110 | ||||||||
| FaxNumber: | 4695899210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2020 | ||||||||
| LastUpdateDate: | 01/04/2021 | ||||||||
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| AuthorizedOfficialLastName: | LEBLANC | ||||||||
| AuthorizedOfficialFirstName: | STEPHANIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8172014457 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.