Provider Demographics
NPI:1467525808
Name:GENCO, FRANK ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ROBERT
Last Name:GENCO
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 1:1104 JOHN MCCAIN RD
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-6315
Mailing Address - Country:US
Mailing Address - Phone:817-503-8800
Mailing Address - Fax:817-503-8801
Practice Address - Street 1:8245 PRECINCT LINE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-1672
Practice Address - Country:US
Practice Address - Phone:817-503-8800
Practice Address - Fax:817-503-8801
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3478207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W1460OtherBCBSTX PROVIDER ID
TXJ3478OtherMEDICAL LICENSE #
TX8W1460OtherBCBSTX PROVIDER ID