Individual
MR. FREDDIE L CONTRERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1002 TEXAS BLVD, STE 406, TEXARKANA, TX 75501-5113
(903) 794-4196
(903) 792-7408
Mailing address
P O BOX 9600, DEPT 09-019, TEXARKANA, TX 75505-9600
(903) 794-4196
(903) 792-7408
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G3244
TX
207T00000X
Neurological Surgery Physician
R3788
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100118890A
—
OK
01
—
104317602
INDIGENT HEALTH CARE
—
05
—
104317602
—
TX
01
—
113561001
MEDICAID
AR
05
—
113561001
—
AR
01
—
140001430
RAILROAD MEDICARE
TX
01
—
179117500
US DEPT OF LABOR
TX
01
—
18382000000
QUALCHOICE OF ARK
AR
01
—
1871793307
CIGNA DME#
TX
01
—
5575000001
CIGNA GOVERNMENT SERVICES
TX
01
—
751716332
UNITED HEALTH CARE
—
01
—
84E967
BLUE CROSS
TX
01
—
90017
BLUE CROSS
AR
01
—
90017
COLLUM & CARNEY CLINIC
TX
01
—
90017
FIRST PYRAMID LIFE
—
01
—
MDG3244
WORKERS' COMPENSATION
TX
Enumeration date
07/29/2005
Last updated
11/18/2009
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