Provider Demographics
NPI:1891730230
Name:FRATER, DIRK A (MD)
Entity Type:Individual
Prefix:
First Name:DIRK
Middle Name:A
Last Name:FRATER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811 TURTLE CREEK BLVD
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8230 WALNUT HILL LN
Practice Address - Street 2:SUITE 818
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-373-3475
Practice Address - Fax:214-373-3476
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0992207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB22781Medicare UPIN