Individual
DR. DAVID K FRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4311 WESLEY ST, GREENVILLE, TX 75401-5639
(903) 455-4458
(903) 455-1604
Mailing address
PO BOX 1908, GREENVILLE, TX 75403-1908
(903) 454-3025
(903) 450-1408
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
14506
NE
208000000X
Pediatrics Physician
Primary
J2568
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130762108
—
TX
01
—
401696YK7L
MEDICARE PTAN
TX
Enumeration date
08/23/2005
Last updated
07/08/2015
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