Provider Demographics
NPI:1982905758
Name:FRANK, JILL RENEE
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:RENEE
Last Name:FRANK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7046
Mailing Address - Country:US
Mailing Address - Phone:512-324-4973
Mailing Address - Fax:512-324-4948
Practice Address - Street 1:3200 RED RIVER ST STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2655
Practice Address - Country:US
Practice Address - Phone:855-481-8375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX500634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280907101Medicaid
TXTXB125995Medicare PIN