Provider Demographics
NPI:1114011087
Name:FRAKER, BRYANT JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:BRYANT
Middle Name:JOSEPH
Last Name:FRAKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 E SAM HOUSTON PKWY N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-7301
Mailing Address - Country:US
Mailing Address - Phone:713-451-8845
Mailing Address - Fax:713-451-8937
Practice Address - Street 1:6830 E SAM HOUSTON PKWY N
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-7301
Practice Address - Country:US
Practice Address - Phone:713-451-8845
Practice Address - Fax:713-451-8937
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11076122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist