Provider Demographics
NPI:1710008545
Name:FRAZIER, KARLA D (DMD, PA)
Entity Type:Individual
Prefix:DR
First Name:KARLA
Middle Name:D
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 E HWY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1526
Mailing Address - Country:US
Mailing Address - Phone:512-453-3879
Mailing Address - Fax:512-452-6795
Practice Address - Street 1:7333 E HWY 290
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1526
Practice Address - Country:US
Practice Address - Phone:512-453-3879
Practice Address - Fax:512-452-6795
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742987716OtherTAX ID NUMBER