Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | J8470 | TX |
Y | 207RP1001X | Pulmonary Disease | J8470 | TX |
NPI | 1013918234 |
---|---|
Provider Name | Dr. Frank A Brancaccio |
First Address | Dallas, TX 75206-5636 |
Second Address | Dallas, TX 75246-7524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 17/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046238403 | (05) | TX |
G42686 | (02) | TX |