Healthcare Provider Details

I. General information

NPI: 1467750612
Provider Name (Legal Business Name): BERT MILTON FRANKS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6812 RIVERRIDGE RD
FT WORTH TX
76116-9355
US

IV. Provider business mailing address

6812 RIVERRIDGE RD
FT WORTH TX
76116-9355
US

V. Phone/Fax

Practice location:
  • Phone: 817-737-8322
  • Fax:
Mailing address:
  • Phone: 817-737-8322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License NumberC8285
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: