Organization
RHETT K FREDRIC, M.D. & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHETT K FREDRIC M.D. (PRESIDENT)
(817) 338-9291
Entity
Organization
Contact information
Practice address
909 9TH AVE, SUITE 402, FORT WORTH, TX 76104-7400
(817) 338-9291
(817) 335-2817
Mailing address
909 9TH AVE, SUITE 402, FORT WORTH, TX 76104-3903
(817) 338-9291
(817) 335-2817
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
E0011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0025WC
BCBS
TX
01
—
0028QJ
BCBS
TX
05
—
175908601
—
TX
01
—
DG4191
MEDICARE RAILROAD
—
Enumeration date
06/06/2007
Last updated
03/24/2011
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