Organization
KELLY J FRASIER M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY JAMES FRASIER M.D. (SOLE PROPRIETOR)
(806) 687-2635
Entity
Organization
Contact information
Practice address
3804 21ST ST, SUITE A, LUBBOCK, TX 79410-1012
(806) 687-2635
(806) 687-2637
Mailing address
3804 21ST ST, SUITE A, LUBBOCK, TX 79410-1012
(806) 687-2635
(806) 687-2637
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M2952
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056NS
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/13/2006
Last updated
12/13/2007
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