Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | 6064 | TX |
N | 111NX0100X | Occupational Health | 6064 | TX |
NPI | 1235269432 |
---|---|
Provider Name | Dr. Robert B. Fraser |
First Address | Mcallen, TX 78504-1903 |
Second Address | Edinburg, TX 78539-5563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 08/07/2007 |