Individual
MR. RONALD DERALD FRYAR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1451 LEXINGTON DRIVE, INGLESIDE, TX 78362
(361) 776-4077
Mailing address
1130 LA MIRADA, PORTLAND, TX 78374-4133
(361) 643-5833
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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