Provider Demographics
NPI:1093991523
Name:FREDERICK E. QUIRANTE, DPM
Entity Type:Organization
Organization Name:FREDERICK E. QUIRANTE, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-729-4225
Mailing Address - Street 1:1323 S 27TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6257
Mailing Address - Country:US
Mailing Address - Phone:409-729-4225
Mailing Address - Fax:409-729-7533
Practice Address - Street 1:1323 S 27TH ST STE 200
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-6257
Practice Address - Country:US
Practice Address - Phone:409-729-4225
Practice Address - Fax:409-729-7533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018601701Medicaid
TX184154601Medicaid
TX00707EMedicare PIN