Provider Demographics
NPI:1346993656
Name:FRATER, ROSIA (MED)
Entity Type:Individual
Prefix:
First Name:ROSIA
Middle Name:
Last Name:FRATER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SUNNY LN
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-2831
Mailing Address - Country:US
Mailing Address - Phone:903-288-4774
Mailing Address - Fax:
Practice Address - Street 1:5612 BELLAIRE DR S APT 101
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76109-3923
Practice Address - Country:US
Practice Address - Phone:972-855-8230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health