Provider Demographics
NPI:1578512679
Name:FRYE, LAURA L (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:L
Last Name:FRYE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 BELTWAY DR
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3705
Mailing Address - Country:US
Mailing Address - Phone:214-535-0073
Mailing Address - Fax:972-661-1291
Practice Address - Street 1:4480 BELTWAY DR
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3705
Practice Address - Country:US
Practice Address - Phone:214-535-0073
Practice Address - Fax:972-661-1291
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080170157OtherRR MEDICARE
TX1460032-01Medicaid
TXH03551Medicare UPIN
TX1460032-01Medicaid