Provider Demographics
NPI:1679887327
Name:FRANOVICH, NICHOLAS MTCHELL
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:MTCHELL
Last Name:FRANOVICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 WILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77378
Mailing Address - Country:US
Mailing Address - Phone:936-525-7080
Mailing Address - Fax:
Practice Address - Street 1:209 EAST WILLWOOD DR
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77378
Practice Address - Country:US
Practice Address - Phone:936-525-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45109109174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist