Provider Demographics
NPI:1447258918
Name:FRADKIN, ALLAN HIRSCH (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:HIRSCH
Last Name:FRADKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7155 OLD KATY RD
Mailing Address - Street 2:N100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2134
Mailing Address - Country:US
Mailing Address - Phone:713-668-6828
Mailing Address - Fax:832-280-3636
Practice Address - Street 1:2302 AVENUE P
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-7932
Practice Address - Country:US
Practice Address - Phone:409-765-6324
Practice Address - Fax:409-765-8475
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD4121207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120557703Medicaid
TX180022436OtherRR MEDICARE
TX87X021Medicare PIN
TX120557703Medicaid