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Individual
JOHN W FREDERICK
Active
Individual
JOHN W FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H0359
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113019102
FIRSTCARE
TX
05
—
138882904
—
TX
05
—
138882909
—
TX
05
—
138882919
—
TX
05
—
138882920
—
TX
01
—
83013K
BCBS
TX
01
—
98085
SCOTT & WHITE
TX
Enumeration date
11/22/2005
Last updated
02/02/2017
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