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Individual

TERRANCE A. FRIED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1008 BROOKLYN AVE, SAN ANTONIO, TX 78215-1617
(210) 228-0743
(210) 228-9749
Mailing address
7142 SAN PEDRO AVE, SUITE 120, SAN ANTONIO, TX 78216-6256
(210) 661-5622
(210) 395-4012

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
F3128
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
125760201
TX
01
390003679
MEDICARE RAILROAD
Enumeration date
12/06/2005
Last updated
08/13/2015
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