Basic Information
Provider Information
NPI: 1174881908
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRZASKA
FirstName: FRANK
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: AA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 201088
Address2:  
City: HOUSTON
State: TX
PostalCode: 772161088
CountryCode: US
TelephoneNumber: 7135003500
FaxNumber: 7135008630
Practice Location
Address1: 6411 FANNIN ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770301501
CountryCode: US
TelephoneNumber: 7135006200
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/30/2012
LastUpdateDate: 03/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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