Provider Demographics
NPI:1134151756
Name:MCGEHEE, FRANK OWEN IV (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:OWEN
Last Name:MCGEHEE
Suffix:IV
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 4035
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79704-4035
Mailing Address - Country:US
Mailing Address - Phone:432-683-3121
Mailing Address - Fax:432-685-3135
Practice Address - Street 1:1811 W WALL ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6531
Practice Address - Country:US
Practice Address - Phone:432-683-3121
Practice Address - Fax:432-685-3135
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2010-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4341208VP0014X, 207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182541602Medicaid
TXM4341OtherMEDICAL LICENSE
TX212072701Medicaid
TX182541602Medicaid
TXI62091Medicare UPIN
TX8F23272Medicare PIN