Provider Demographics
NPI: | 1740263565 |
---|---|
Name: | FRANCO, MIGUEL ANGEL JR (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | MIGUEL |
Middle Name: | ANGEL |
Last Name: | FRANCO |
Suffix: | JR |
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: | 1201 DAIRY ASHFORD |
Mailing Address - Street 2: | SUITE 200 |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77079-3017 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-407-3000 |
Mailing Address - Fax: | 713-407-3018 |
Practice Address - Street 1: | 16001 PARK TEN PL STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77084-7885 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-407-3000 |
Practice Address - Fax: | 713-407-3018 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-11-25 |
Last Update Date: | 2019-11-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | G0905 | 207R00000X, 207RP1001X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 42999501 | Medicaid | |
TX | 844038 | Medicare PIN | |
TX | D49606 | Medicare UPIN |