Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 011172 | LA |
N | 2080P0214X | Pediatric Pulmonologist | C32624 | CA |
NPI | 1093836496 |
---|---|
Provider Name | Ralph Coryell Frates JR. |
First Address | Houston, TX 77005-3360 |
Second Address | Houston, TX 77002-7497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |