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Individual
MR. FRED M. FRY
Active
Individual
MR. FRED M. FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D6266
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K800
BLUECROSS BLUESHIELD
TX
01
—
4378838
AETNA
TX
Enumeration date
07/12/2006
Last updated
07/09/2007
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