# FRED M FRY, MD, ASSOC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841494671
- **Authorized official:** MS. KATHY G HAMILTON (PATIENT ACCOUNTS)
- **Authorized official phone:** (361) 573-6351

## Contact information

- **Practice address:** 2501 N NAVARRO ST, VICTORIA, TX 77901-3912
- **Practice address phone:** (361) 573-6351
- **Practice address fax:** (361) 575-6455
- **Mailing address:** 2501 N NAVARRO ST, VICTORIA, TX 77901-3912

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | D6266 | TX | Yes |

## Other

- **Enumeration date:** 06/14/2007
- **Last updated:** 06/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0072PZ | BLUE CROSS BLUE SHIELD | TX |
| 05 | — | 089913001 | — | TX |
| 01 | — | 342445479 | RAILROAD MEDICARE | TX |
| 01 | — | 4378830 | AETNA | TX |