Provider Demographics
NPI:1598977761
Name:FRANCO, ZURISADAI (MD)
Entity type:Individual
Prefix:DR
First Name:ZURISADAI
Middle Name:
Last Name:FRANCO
Suffix:
Gender:F
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 6278
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-0278
Mailing Address - Country:US
Mailing Address - Phone:817-551-6506
Mailing Address - Fax:817-551-0629
Practice Address - Street 1:11803 SOUTH FWY STE 360
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7012
Practice Address - Country:US
Practice Address - Phone:817-551-6506
Practice Address - Fax:817-551-0629
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5056207R00000X
OH35091341207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35091341OtherOHIO MEDICAL LICENSE
OH2843883Medicaid
OH4236622Medicare PIN