Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | G5962 | TX |
NPI | 1609807312 |
---|---|
Provider Name | Fredrick A Mccurdy |
First Address | Corpus Christi, TX 78401-0799 |
Second Address | Corpus Christi, TX 78411-1721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 17/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
156499901 | (05) | TX |
200061450A | OKLAHOMA MEDICAID (01) | OK |
82950571 | NEW MEXICO MEDICAID (01) | NM |
F62669 | (02) |