# FRONTIER ANESTHESIA MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417476524
- **Authorized official:** TRACY WALLS (PRESIDENT)
- **Authorized official phone:** (972) 234-4740

## Contact information

- **Practice address:** 2001 COOPER ST, FORT WORTH, TX 76104-2529
- **Practice address phone:** (972) 234-4740
- **Practice address fax:** (972) 231-7095
- **Mailing address:** PO BOX 674394, DALLAS, TX 75267-4394

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2017
- **Last updated:** 09/11/2017