Provider Demographics
NPI:1932279221
Name:MEDINA, FRANCISCO S (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:S
Last Name:MEDINA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:FRANCISCO
Other - Middle Name:S
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOPA
Mailing Address - Street 1:528 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208
Mailing Address - Country:US
Mailing Address - Phone:214-941-5028
Mailing Address - Fax:
Practice Address - Street 1:528 CENTRE ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-941-5028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7188207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D79614Medicare UPIN