Organization
AUSTIN GERIATRIC SPECIALISTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIAM M FRY MD (OWNER)
(877) 856-3774
Entity
Organization
Contact information
Practice address
12731 RESEARCH BLVD STE B200, AUSTIN, TX 78759
(877) 856-3774
(512) 482-0390
Mailing address
1108 LAVACA ST STE 110-320, AUSTIN, TX 78701-2172
(877) 856-3774
(239) 599-2625
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00049F
BCBS OF TEXAS
TX
05
—
079678101
—
TX
01
—
CG1751
MEDICARE RAILROAD
TX
01
—
CI5689
TRAVELERS/MEDICARE RAILROAD
TX
Enumeration date
07/07/2006
Last updated
02/16/2024
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