Provider Demographics
NPI:1356501092
Name:FRIES, RICHARD C (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:FRIES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3248 W 7TH ST
Mailing Address - Street 2:APT 331
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-2768
Mailing Address - Country:US
Mailing Address - Phone:817-353-9952
Mailing Address - Fax:
Practice Address - Street 1:200 FELIKS GWOZDZ PL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4919
Practice Address - Country:US
Practice Address - Phone:817-920-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7914207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology