Provider Demographics
NPI:1831084680
Name:FREEFORMPROSPER PLLC
Entity type:Organization
Organization Name:FREEFORMPROSPER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-830-9860
Mailing Address - Street 1:2772 STONEBROOK PKWY STE 900
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1579
Mailing Address - Country:US
Mailing Address - Phone:469-777-4533
Mailing Address - Fax:
Practice Address - Street 1:2350 E PROSPER TRL TRLR 20
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-3882
Practice Address - Country:US
Practice Address - Phone:469-391-8917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty