Individual
DR. PETER R DEFRANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7709 ALTO CARO DR, DALLAS, TX 75248-4303
(214) 866-5313
(972) 947-3976
Mailing address
7709 ALTO CARO DR, DALLAS, TX 75248-4303
(214) 866-5313
(972) 947-3976
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
0866
TX
213ES0131X
Foot Surgery Podiatrist
Primary
0866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112216007
—
TX
05
—
112216008
—
TX
05
—
112216009
—
TX
05
—
112216010
—
TX
01
—
75-2018765
TAX ID
TX
01
—
P01242887
RAILROAD MEDICARE
TX
Enumeration date
02/24/2006
Last updated
03/03/2015
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