Provider Demographics
NPI:1366680811
Name:FRANK J. CHERPACK, DPM
Entity Type:Organization
Organization Name:FRANK J. CHERPACK, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCY
Authorized Official - Middle Name:
Authorized Official - Last Name:MENKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-251-6414
Mailing Address - Street 1:PO BOX 202734
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78720-2734
Mailing Address - Country:US
Mailing Address - Phone:512-343-8834
Mailing Address - Fax:512-343-8854
Practice Address - Street 1:8701 SHOAL CREEK BLVD
Practice Address - Street 2:STE 102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-6864
Practice Address - Country:US
Practice Address - Phone:512-343-8834
Practice Address - Fax:512-343-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1198332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5359260001Medicare NSC