Provider Demographics
NPI:1194057240
Name:STEFKA, FRANK JONATHAN (MSPT)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JONATHAN
Last Name:STEFKA
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4000
Mailing Address - Country:US
Mailing Address - Phone:361-237-1670
Mailing Address - Fax:361-237-1703
Practice Address - Street 1:1101 E AIRLINE RD
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4000
Practice Address - Country:US
Practice Address - Phone:361-237-1670
Practice Address - Fax:361-237-1703
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-30
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1135507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX390840201Medicaid