Provider Demographics
NPI:1073820593
Name:RONALD M. FRIEDMAN, M.D., P.A.
Entity Type:Organization
Organization Name:RONALD M. FRIEDMAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-467-0100
Mailing Address - Street 1:PO BOX 866365
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6365
Mailing Address - Country:US
Mailing Address - Phone:469-467-0100
Mailing Address - Fax:469-467-0105
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:SUITE 232
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8122
Practice Address - Country:US
Practice Address - Phone:469-467-0100
Practice Address - Fax:469-467-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9515174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF92658Medicare UPIN
TX0033ADMedicare PIN