Provider Demographics
NPI:1609804913
Name:FRAZIER, MERIWETHER LEWIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MERIWETHER
Middle Name:LEWIS
Last Name:FRAZIER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5425 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4236
Mailing Address - Country:US
Mailing Address - Phone:972-423-5679
Mailing Address - Fax:972-612-5410
Practice Address - Street 1:5425 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4236
Practice Address - Country:US
Practice Address - Phone:972-423-5679
Practice Address - Fax:972-612-5410
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9037208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPOO666112OtherRAILROAD MEDICARE
TX8X9700OtherBLUE CROSS BLUE SHIELD
TX8X9700OtherBLUE CROSS BLUE SHIELD
TXPOO666112OtherRAILROAD MEDICARE
TX8K7338Medicare PIN