Individual
PATRICK R FREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1625 LANCASTER DR, GRAPEVINE, TX 76051
(214) 915-8502
(682) 223-5006
Mailing address
3600 GASTON AVE STE 1205, DALLAS, TX 75246-1812
(214) 692-8262
(214) 853-9415
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
K9062
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100723901
—
TX
05
—
100723902
—
TX
05
—
100723903
—
TX
05
—
100723904
—
TX
01
—
100723905
MEDICAID OTHER
TX
05
—
100723906
—
TX
Enumeration date
09/21/2005
Last updated
09/11/2018
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