Provider Demographics
NPI:1659358000
Name:BIRDSELL, FRANK NANCE (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:NANCE
Last Name:BIRDSELL
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:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:972-715-5000
Practice Address - Street 1:1301 PENNSYLVANIA AVE.
Practice Address - Street 2:SRP 2 - ROOM 73
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76401
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7436207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8EH322OtherBCBS
TX129329208Medicaid
TX129329202Medicaid
TX129329201Medicaid
TX129329207Medicaid
TX129329210Medicaid
TX83878KOtherBCBS
TX050065318OtherRAILROAD
TX129329209Medicaid
TX129329202Medicaid
TX8EH322OtherBCBS
TX129329209Medicaid
TX129329208Medicaid
TX338914YK6UMedicare PIN