Provider Demographics
NPI:1306028824
Name:FRANK C KRETSINGER, D.O., PA
Entity Type:Organization
Organization Name:FRANK C KRETSINGER, D.O., PA
Other - Org Name:FRANK C KRETSINGER, D.O., PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:C
Authorized Official - Last Name:KRETSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-599-8300
Mailing Address - Street 1:311 CAMDEN ST
Mailing Address - Street 2:SUITE 409
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-2012
Mailing Address - Country:US
Mailing Address - Phone:210-599-8300
Mailing Address - Fax:210-599-8391
Practice Address - Street 1:311 CAMDEN ST
Practice Address - Street 2:SUITE 409
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2012
Practice Address - Country:US
Practice Address - Phone:210-599-8300
Practice Address - Fax:210-599-8853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6841207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170486801Medicaid
TXA67299Medicare UPIN
TX170486801Medicaid