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General NPI Number Information
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NPI Number | 1093145211
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Entity Type | Individual
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Provider Name | FRANK ANDRES BAZAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 11/25/2013
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Provider Practice Location Address
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Address Line | 1200 E SPRING CREEK PKWY
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City | PLANO
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State | TX
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Zip | 75074-3023
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Country | US
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Telephone | 972-422-1047
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Fax | 972-423-9616
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Provider Business Mailing Address
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Address Line | 6101 LOUISVILLE DR
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City | FRISCO
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State | TX
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Zip | 75035-8330
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Country | US
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Telephone | 214-236-4685
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TX 03913
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License Number State | TX
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