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EFOSA AIRUEHIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11330 LEGACY DR STE 103, FRISCO, TX 75033-1210
(469) 777-4691
(469) 777-4542
Mailing address
11330 LEGACY DR STE 103, FRISCO, TX 75033-1210
(469) 777-4691
(469) 777-4542

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Q2227
TX
2084P0800X
Psychiatry Physician
2011027713
MO
2084P0800X
Psychiatry Physician
Primary
Q2227
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Q2227
TX

Other

Enumeration date
07/18/2008
Last updated
09/26/2024
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