Individual
FRANKLIN O. HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4545 FULLER DRIVE, SUITE 325, IRVING, TX 75038-6521
(972) 870-5511
(972) 870-5512
Mailing address
PO BOX 1239, TROY, MI 48099-1239
(248) 824-6600
(248) 324-1477
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K4081
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106257201
—
TX
05
—
106257204
—
TX
05
—
106257205
—
TX
05
—
106257207
—
TX
05
—
106257209
—
TX
05
—
106257211
—
TX
05
—
106257213
—
TX
05
—
106257215
—
TX
05
—
106257216
—
TX
05
—
106257218
—
TX
05
—
106257219
—
TX
05
—
106257221
—
TX
05
—
106257222
—
TX
01
—
84675F
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/06/2005
Last updated
07/31/2013
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