Provider Demographics
NPI:1699985937
Name:FRISCO OBSTETRICS AND GYNECOLOGY, PA
Entity type:Organization
Organization Name:FRISCO OBSTETRICS AND GYNECOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-731-9299
Mailing Address - Street 1:4461 COIT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0521
Mailing Address - Country:US
Mailing Address - Phone:972-731-9299
Mailing Address - Fax:972-731-9909
Practice Address - Street 1:4461 COIT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-0521
Practice Address - Country:US
Practice Address - Phone:972-731-9299
Practice Address - Fax:972-731-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0063MAOtherBCBS
TX658644OtherAETNA
TX172918801Medicaid