Provider Demographics
NPI:1619976628
Name:SENKOWSKY, FRANK JON (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JON
Last Name:SENKOWSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JON
Other - Middle Name:
Other - Last Name:SENKOWSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4201 INTERWAY PL STE 100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-5668
Mailing Address - Country:US
Mailing Address - Phone:817-735-1180
Mailing Address - Fax:866-861-2145
Practice Address - Street 1:4201 INTERWAY PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-5668
Practice Address - Country:US
Practice Address - Phone:817-735-1180
Practice Address - Fax:866-861-2145
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG55942086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172353804Medicaid
TX172353804Medicaid
TX354346YKPWMedicare PIN