Provider Demographics
NPI:1932304805
Name:FRAGA SALIDO INC.
Entity Type:Organization
Organization Name:FRAGA SALIDO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HOBLIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-266-5297
Mailing Address - Street 1:111 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5618
Mailing Address - Country:US
Mailing Address - Phone:972-266-5297
Mailing Address - Fax:214-975-2793
Practice Address - Street 1:111 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5618
Practice Address - Country:US
Practice Address - Phone:972-266-5297
Practice Address - Fax:214-975-2793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty