# FRONTLINE MOBILE HEALTH

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

## Provider details

- **NPI number:** 1902686116
- **Authorized official:** RUSSELL BURNHAM APA-C (CEO)
- **Authorized official phone:** (512) 838-3808

## Contact information

- **Practice address:** 6517 N LAKEWOOD DR, GEORGETOWN, TX 78633-9530
- **Practice address phone:** (512) 838-3808
- **Practice address fax:** (512) 253-2861
- **Mailing address:** 6517 N LAKEWOOD DR, GEORGETOWN, TX 78633-9530
- **Mailing address phone:** (512) 838-3808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/04/2023
- **Last updated:** 10/04/2023