Provider Demographics
NPI:1548982572
Name:PALACIOS, FRANK (CSFA)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:PALACIOS
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21750 HARDY OAK BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4946
Mailing Address - Country:US
Mailing Address - Phone:254-498-1374
Mailing Address - Fax:
Practice Address - Street 1:21750 HARDY OAK BLVD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4946
Practice Address - Country:US
Practice Address - Phone:254-498-1374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210645363AS0400X
363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty