Provider Demographics
NPI:1689058943
Name:FREYSURGICAL LLC
Entity Type:Organization
Organization Name:FREYSURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-456-5765
Mailing Address - Street 1:PO BOX 51293
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1293
Mailing Address - Country:US
Mailing Address - Phone:337-456-5765
Mailing Address - Fax:337-456-6657
Practice Address - Street 1:129 RUE LOUIS XIV
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5738
Practice Address - Country:US
Practice Address - Phone:337-456-5765
Practice Address - Fax:337-456-6657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty