Provider Demographics
NPI:1770252231
Name:FRAZIER, AARON WAYNE
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:WAYNE
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 FM 1092 RD STE D
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1588
Mailing Address - Country:US
Mailing Address - Phone:832-440-7061
Mailing Address - Fax:
Practice Address - Street 1:1100 FM 1092 RD STE D
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1588
Practice Address - Country:US
Practice Address - Phone:832-440-7061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy