Provider Demographics
NPI:1023063195
Name:QUIRANTE, FREDERICK ELEFANO (DPM)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:ELEFANO
Last Name:QUIRANTE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1323 S 27TH STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627
Mailing Address - Country:US
Mailing Address - Phone:409-729-4225
Mailing Address - Fax:409-729-7533
Practice Address - Street 1:1323 S 27TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627
Practice Address - Country:US
Practice Address - Phone:409-729-4225
Practice Address - Fax:409-729-7533
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1471213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0044DZOtherBCBS
TX018601701Medicaid
U72460Medicare UPIN
TX00707EMedicare ID - Type Unspecified