Provider Demographics
NPI:1639119654
Name:OLIVER, FRANK EDMOND (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:EDMOND
Last Name:OLIVER
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 1:7777 FOREST LN
Mailing Address - Street 2:SUITE A317
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:972-566-6616
Mailing Address - Fax:972-566-8545
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE A317
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-6616
Practice Address - Fax:972-566-8545
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4184207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0059CCOtherGROUP BCBS
TX0059CCOtherGROUP BCBS
TXC20034Medicare UPIN