Provider Demographics
NPI:1609807312
Name:MCCURDY, FREDRICK A (MD, PHD, MBA)
Entity Type:Individual
Prefix:
First Name:FREDRICK
Middle Name:A
Last Name:MCCURDY
Suffix:
Gender:M
Credentials:MD, PHD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3533 S ALAMEDA ST STE 210
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1721
Mailing Address - Country:US
Mailing Address - Phone:361-694-5022
Mailing Address - Fax:361-808-2154
Practice Address - Street 1:3533 S ALAMEDA ST STE 210
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1721
Practice Address - Country:US
Practice Address - Phone:361-694-5022
Practice Address - Fax:361-808-2064
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG59622080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2D4446OtherMEDICARE
TXENROLLEDMedicaid
OK200061450AOtherOKLAHOMA MEDICAID
TX8L19906Medicare Oscar/Certification
F62669Medicare UPIN
TX8A3810Medicare ID - Type Unspecified