Provider Demographics
NPI:1932278058
Name:FRAKTAN LLC
Entity type:Organization
Organization Name:FRAKTAN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BREGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-687-8277
Mailing Address - Street 1:6209 IMOGENE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-7511
Mailing Address - Country:US
Mailing Address - Phone:832-606-1638
Mailing Address - Fax:713-621-9673
Practice Address - Street 1:6209 IMOGENE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-7511
Practice Address - Country:US
Practice Address - Phone:832-606-1638
Practice Address - Fax:713-621-9673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800203341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance