Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2606 TG | TX |
NPI | 1164595799 |
---|---|
Provider Name | Dr. David Robert Frazee |
First Address | Richardson, TX 75081-2427 |
Second Address | Richardson, TX 75081-2427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 30/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
OOE70A | BCBS (01) | TX |
T13322 | (02) | TX |
TX2606 | EYEMED VISION (01) | TX |