Organization
FRED M FRY, MD, ASSOC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY G HAMILTON (PATIENT ACCOUNTS)
(361) 573-6351
Entity
Organization
Contact information
Practice address
2501 N NAVARRO ST, VICTORIA, TX 77901-3912
(361) 573-6351
(361) 575-6455
Mailing address
2501 N NAVARRO ST, VICTORIA, TX 77901-3912
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D6266
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072PZ
BLUE CROSS BLUE SHIELD
TX
05
—
089913001
—
TX
01
—
342445479
RAILROAD MEDICARE
TX
01
—
4378830
AETNA
TX
Enumeration date
06/14/2007
Last updated
06/20/2008
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