Healthcare Provider Details

I. General information

NPI: 1689265431
Provider Name (Legal Business Name): OPCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15126 CANE HARBOR BLVD
CORPUS CHRISTI TX
78418-7601
US

IV. Provider business mailing address

15126 CANE HARBOR BLVD
CORPUS CHRISTI TX
78418-7601
US

V. Phone/Fax

Practice location:
  • Phone: 361-442-5588
  • Fax: 888-858-1409
Mailing address:
  • Phone: 361-442-5588
  • Fax: 888-858-1409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTONIO B FRATILA
Title or Position: OWNER/SOLE MEMBER
Credential: MD
Phone: 361-442-5588