Individual
DR. FRANK EDWIN PRUKOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1133 GENERAL CAVAZOS BLVD, KINGSVILLE, TX 78363-7100
(361) 516-0888
(361) 516-0880
Mailing address
200 REIDDA DR, KINGSVILLE, TX 78363-7701
(361) 595-4421
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5487T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0054FB
BCBS PROVIDER #
TX
01
—
14919
SPECTERA PROVIDER ID
TX
01
—
25812
OPTICARE PROVIDER #
TX
01
—
44212
DAVIS VISION PROVIDER #
TX
01
—
454087
NVA PROVIDER #
TX
01
—
5487T
LICENSE #
TX
01
—
919677
BLOCK VISION PROVIDER ID#
TX
Enumeration date
02/23/2007
Last updated
03/07/2023
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