Provider Demographics
NPI:1164545521
Name:FRY, JAMES ANDREW (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ANDREW
Last Name:FRY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 GRAND AVENUE PARKWAY
Mailing Address - Street 2:STE. #110
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660
Mailing Address - Country:US
Mailing Address - Phone:512-251-2708
Mailing Address - Fax:512-900-2795
Practice Address - Street 1:821 GRAND AVENUE PARKWAY
Practice Address - Street 2:STE. #110
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660
Practice Address - Country:US
Practice Address - Phone:512-251-2708
Practice Address - Fax:512-900-2795
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4243106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist