Provider Demographics
NPI:1750426763
Name:FRANK LANE, MD, PC
Entity type:Organization
Organization Name:FRANK LANE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-826-9599
Mailing Address - Street 1:11141 GEORGIA AVE
Mailing Address - Street 2:SUITE 326
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4637
Mailing Address - Country:US
Mailing Address - Phone:301-565-2250
Mailing Address - Fax:301-565-2159
Practice Address - Street 1:3030 NACOGDOCHES RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4540
Practice Address - Country:US
Practice Address - Phone:210-826-9599
Practice Address - Fax:301-565-2159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD16982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC18135Medicare UPIN
TX00830VMedicare ID - Type Unspecified