Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2127 | TX |
Y | 213E00000X | Podiatrist | 2127 | TX |
Y | 222Z00000X | Podiatrist | 2127 | TX |
N | 213EP0504X | Public Medicine | 2127 | TX |
N | 213EP1101X | Primary Podiatric Medicine | 2127 | TX |
N | 111NR0200X | Radiology | 2127 | TX |
N | 213ER0200X | Radiology | 2127 | TX |
N | 2081S0010X | Sports Medicine | 2127 | TX |
N | 213ES0000X | Sports Medicine | 2127 | TX |
N | 213ES0103X | Foot & Ankle Surgery | 2127 | TX |
N | 213ES0131X | Foot Surgery | 2127 | TX |
NPI | 1881958940 |
---|---|
Provider Name | Dr. Michael James Frazier SR. |
First Address | Cypress, TX 77429-5136 |
Second Address | Cypress, TX 77429-5136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2012 |
Last Update Date | 28/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
346895101 | (05) | TX |
346895104 | (05) | TX |