Individual
DR. BECKY JO FREDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.,PH.D.
Contact information
Practice address
1415 NORTH LOOP W STE 400, HOUSTON, TX 77008-1646
(713) 869-6400
(713) 869-6498
Mailing address
2855 GRAMERCY ST STE 400, HOUSTON, TX 77025-1697
(713) 668-6828
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L3649
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176478903
—
TX
Enumeration date
07/28/2005
Last updated
03/19/2021
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