Provider Demographics
NPI:1285728055
Name:SLOAN, FRANK J (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:SLOAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-885-4446
Mailing Address - Fax:817-810-1396
Practice Address - Street 1:1401 W PULASKI ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2717
Practice Address - Country:US
Practice Address - Phone:682-885-8012
Practice Address - Fax:682-885-8014
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7191207PP0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7615505OtherAETNA PIN
TX8A0219OtherBCBSTX IND PIN
TX136724100OtherFIRSTCARE PIN
TN00L42VOtherBCBSTX GRP PIN
TX10010829OtherAMERIGROUP PIN
TX160633710Medicaid
TX080626701Medicaid
TX1633140101Medicaid
TX115004OtherSUPERIOR PIN
TX2123000OtherFIRSTHEALTH PIN
TX160633706Medicaid
TX160633704Medicaid
TX160633711OtherMEDICAID CSHCN
TX1011706OtherCIGNA PIN
1669442042OtherGRP NPI NUMBER
TX1633140101Medicaid