Healthcare Provider Details
I. General information
NPI: 1497956734
Provider Name (Legal Business Name): FRANK JOSEPH PONCE III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/31/2007
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7219 FAIRMONT PKWY STE 180
PASADENA TX
77505-4611
US
IV. Provider business mailing address
4001 PRESTON AVE SUITE 110
PASADENA TX
77505-2069
US
V. Phone/Fax
- Phone: 281-487-3443
- Fax: 281-487-3461
- Phone: 281-249-2273
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 0101244085 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | N3996 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: