Provider Demographics
NPI:1326041161
Name:FRACHTMAN, RICHARD JULIAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JULIAN
Last Name:FRACHTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 FROSTWOOD DR
Mailing Address - Street 2:STE 275
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2445
Mailing Address - Country:US
Mailing Address - Phone:713-461-3573
Mailing Address - Fax:713-468-1247
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:STE 275
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2445
Practice Address - Country:US
Practice Address - Phone:713-461-3573
Practice Address - Fax:713-468-1247
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE84772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81545ROtherBLUE CROSS BLUE SHIELD
B22775Medicare UPIN
TX81545ROtherBLUE CROSS BLUE SHIELD