Basic Information
| Provider Information | |||||||||
| NPI: | 1902852346 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FRISCO EYE ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 208904 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753208904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6362004393 | ||||||||
| FaxNumber: | 6365270766 | ||||||||
| Practice Location | |||||||||
| Address1: | 7638 STONEBROOK PKWY | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750341003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727121010 | ||||||||
| FaxNumber: | 9727121011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 10/19/2022 | ||||||||
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| AuthorizedOfficialLastName: | GIRA | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | PRAVOOT | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6362004393 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 1588611172 | 01 | TX | BCBS-DR. BITA GARZA | OTHER | 82954Q | 01 | TX | BCBS - AMBER PAULSEN | OTHER | 1871828061 | 01 | TX | AMBER PAULSEN NPI | OTHER | 1902852346 | 01 | TX | GROUP NPI | OTHER | 1336131960 | 01 | TX | JEFF THOMAS NPI | OTHER | 1487696811 | 01 | TX | DANA BIEDERMAN NPI | OTHER | 1487696811 | 01 | TX | BCBS-DR. DANA BIEDERMAN | OTHER | 1588611172 | 01 | TX | BITA GARZA NPI | OTHER | 1881686426 | 01 | TX | BCBS- DR. COLY MARSH | OTHER | 1881686426 | 01 | TX | COLY MARSH NPI | OTHER | 00E41Y | 01 | TX | BCBS | OTHER | 1336131960 | 01 | TX | BCBS-DR. JEFF THOMAS | OTHER |