Organization Name: | CRAIG FREYER, M.D. |
NPI Number: | 1710133897 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CRAIG A FREYER (OWNER) |
Mailing Address: | 3629 Western Center Blvd Suite 201 Fort Worth |
State: | TX US |
Postal Code: | 761371939 |
Phone Number: | 8172329870 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2008 |
NPI Last Update Date: | 08/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G5062 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |