Basic Information
| Provider Information | |||||||||
| NPI: | 1649270604 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIEDENBACH | ||||||||
| FirstName: | THERESA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5728 EUREKA BND | ||||||||
| Address2: | |||||||||
| City: | MCKINNEY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750702645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328872229 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1650 W COLLEGE ST | ||||||||
| Address2: | |||||||||
| City: | GRAPEVINE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760513565 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8173292502 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2005 | ||||||||
| LastUpdateDate: | 10/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 25MP00057800 | NJ | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 363A00000X | PA06721 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.