Basic Information
Provider Information
NPI: 1912633884
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FROHLING
FirstName: AMY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RBT-22-224601
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 419 CARSON HL STE 202
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782515500
CountryCode: US
TelephoneNumber: 2106341129
FaxNumber:  
Practice Location
Address1: 419 CARSON HL STE 202
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782515500
CountryCode: US
TelephoneNumber: 2106341129
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2022
LastUpdateDate: 07/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106S00000XRBT-22-224601TXY    

No ID Information.


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