Healthcare Provider Details

I. General information

NPI: 1902208424
Provider Name (Legal Business Name): FRANK FRANCISCO O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 TIN VALLEY CIR STE A
BIRMINGHAM AL
35235-3248
US

IV. Provider business mailing address

PO BOX 207243
DALLAS TX
75320-7243
US

V. Phone/Fax

Practice location:
  • Phone: 205-661-2020
  • Fax: 205-661-2010
Mailing address:
  • Phone: 636-200-4393
  • Fax: 636-527-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-D25-TA-A05
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: