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Organization
DR. FREDRIC PUCKETT, PLLC
Active
Organization
DR. FREDRIC PUCKETT, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDRIC CLARK PUCKETT DO (PHYSICIAN/OWNER)
(972) 875-6200
Entity
Organization
Contact information
Practice address
2203 W LAMPASAS ST STE 111, ENNIS, TX 75119-5667
(972) 875-6200
(972) 875-6414
Mailing address
2203 W LAMPASAS ST STE 111, ENNIS, TX 75119-5667
(972) 875-6200
(972) 875-6414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
05/27/2009
Last updated
06/13/2024
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