Provider Demographics
NPI:1326021015
Name:FRIERSON, JOHN HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HOWARD
Last Name:FRIERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 BROOKLYN AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-4816
Mailing Address - Country:US
Mailing Address - Phone:210-271-7266
Mailing Address - Fax:210-226-8411
Practice Address - Street 1:1200 BROOKLYN AVE
Practice Address - Street 2:STE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4816
Practice Address - Country:US
Practice Address - Phone:210-271-7266
Practice Address - Fax:210-226-8411
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG3371207RC0000X, 207RI0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB9403JMedicare UPIN