Basic Information
Provider Information
NPI: 1023056553
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARD
FirstName: FRANK
MiddleName: T
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 911230
Address2:  
City: DALLAS
State: TX
PostalCode: 753911230
CountryCode: US
TelephoneNumber: 9729978000
FaxNumber: 9724379605
Practice Location
Address1: 910 E HOUSTON ST
Address2:  
City: TYLER
State: TX
PostalCode: 757028369
CountryCode: US
TelephoneNumber: 9035799800
FaxNumber: 9035264463
Other Information
ProviderEnumerationDate: 06/04/2006
LastUpdateDate: 01/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202XK7412TXN Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
207RH0003XK7412TXY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
11658960505TX MEDICAID
11658960405TX MEDICAID
11658960205TX MEDICAID
11658960105TX MEDICAID
8R158001TXBLUE CROSS OF TEXASOTHER


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