Provider Demographics
NPI:1497711840
Name:JIRCIK, FRANK PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:PAUL
Last Name:JIRCIK
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 1:12001 SOUTH FWY STE 304
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7215
Mailing Address - Country:US
Mailing Address - Phone:817-551-5400
Mailing Address - Fax:817-568-0961
Practice Address - Street 1:12001 SOUTH FWY STE 304
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7215
Practice Address - Country:US
Practice Address - Phone:817-551-5400
Practice Address - Fax:817-568-0961
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9621174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB23768Medicare UPIN
TX00QV87TMedicare ID - Type Unspecified