Provider Demographics
NPI:1992775407
Name:VANFRANK, TIMOTHY DEAN (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DEAN
Last Name:VANFRANK
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 1:6421 SARATOGA BLVD
Mailing Address - Street 2:BLDG - 106
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3480
Mailing Address - Country:US
Mailing Address - Phone:361-991-7109
Mailing Address - Fax:361-991-5213
Practice Address - Street 1:6421 SARATOGA BLVD
Practice Address - Street 2:BLDG - 106
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3480
Practice Address - Country:US
Practice Address - Phone:361-991-7109
Practice Address - Fax:361-991-5213
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3512174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0410359 01Medicaid
TX0410359 01Medicaid
TXG47798Medicare UPIN