Provider Demographics
NPI:1174512107
Name:ROBERT H FRIEDMAN MD PA
Entity Type:Organization
Organization Name:ROBERT H FRIEDMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-578-6868
Mailing Address - Street 1:21376 PROVINCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7580
Mailing Address - Country:US
Mailing Address - Phone:281-578-6868
Mailing Address - Fax:281-578-6869
Practice Address - Street 1:21376 PROVINCIAL BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7580
Practice Address - Country:US
Practice Address - Phone:281-578-6868
Practice Address - Fax:281-578-6869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2423207V00000X
CAG12840207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
26584OtherAMERI GROUP
683630OtherAETNA
826163120OtherRR MEDICARE
P1465520OtherOXFORD
0382207OtherAMERIHEALTH
TX0096MDOtherBCBS
TX035059701Medicaid
683630OtherAETNA
TX035059701Medicaid