Provider Demographics
NPI:1255812228
Name:FRANK P. JIRCIK MD
Entity type:Organization
Organization Name:FRANK P. JIRCIK MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:JIRCIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-551-5400
Mailing Address - Street 1:12001 SOUTH FWY STE 304
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7215
Mailing Address - Country:US
Mailing Address - Phone:817-551-5400
Mailing Address - Fax:817-568-0961
Practice Address - Street 1:12001 SOUTH FWY STE 304
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7215
Practice Address - Country:US
Practice Address - Phone:817-551-5400
Practice Address - Fax:817-568-0961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty