Provider Demographics
NPI:1952376345
Name:DEHNISCH, FRANK RAYMOND JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:RAYMOND
Last Name:DEHNISCH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:210 E CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-4810
Mailing Address - Country:US
Mailing Address - Phone:361-362-3648
Mailing Address - Fax:362-288-1593
Practice Address - Street 1:1602 E HOUSTON ST
Practice Address - Street 2:SUITE C
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5326
Practice Address - Country:US
Practice Address - Phone:361-358-9200
Practice Address - Fax:361-358-5513
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8190207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138712806Medicaid
TX89016BOtherBLUE CROSS
TX138712814Medicaid
TX8A6126Medicare PIN
TX89016BOtherBLUE CROSS
TXB22192Medicare UPIN
TX138712814Medicaid