Provider Demographics
NPI:1922038181
Name:FAUSTUS, FRANK (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:FAUSTUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 960046
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0001
Mailing Address - Country:US
Mailing Address - Phone:888-447-2450
Mailing Address - Fax:405-341-9217
Practice Address - Street 1:1600 HOSPITAL PKWY
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6913
Practice Address - Country:US
Practice Address - Phone:817-570-8500
Practice Address - Fax:405-341-9217
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084574207P00000X
TXM7174207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00472942OtherRAILROAD MEDICARE
TX191435001Medicaid
OH2510796Medicaid
OHP00360545OtherRAILROAD MEDICARE
TX8AB542OtherBCBS
OHP00392699OtherRAILROAD MEDICARE
OH2510796Medicaid
OHFA4142523Medicare PIN
TXP00472942OtherRAILROAD MEDICARE
TX8AB542OtherBCBS