Provider Demographics
NPI:1669618500
Name:FRACHTMAN, STEVEN JAY (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAY
Last Name:FRACHTMAN
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 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-3372
Mailing Address - Fax:713-797-0622
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-3372
Practice Address - Fax:713-797-0622
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP2239207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX355398401Medicaid
TX8FT497OtherBLUE CROSS BLUE SHIELD
TX355398402Medicaid
TX8FT496OtherBLUE CROSS BLUE SHIELD
TX311187YMVQMedicare PIN
TX311187ZSWDMedicare PIN