Provider Demographics
| NPI: | 1740263565 |
|---|---|
| Name: | FRANCO, MIGUEL ANGEL JR (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | MIGUEL |
| Middle Name: | ANGEL |
| Last Name: | FRANCO |
| Suffix: | JR |
| 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: | 1201 DAIRY ASHFORD |
| Mailing Address - Street 2: | SUITE 200 |
| Mailing Address - City: | HOUSTON |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77079-3017 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 713-407-3000 |
| Mailing Address - Fax: | 713-407-3018 |
| Practice Address - Street 1: | 16001 PARK TEN PL STE 300 |
| Practice Address - Street 2: | |
| Practice Address - City: | HOUSTON |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77084-7885 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 713-407-3000 |
| Practice Address - Fax: | 713-407-3018 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2005-11-25 |
| Last Update Date: | 2019-11-12 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | G0905 | 207R00000X, 207RP1001X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 42999501 | Medicaid | |
| TX | 844038 | Medicare PIN | |
| TX | D49606 | Medicare UPIN |