Provider Demographics
NPI:1184126328
Name:MICHAEL FRAZIER DPM PLLC
Entity type:Organization
Organization Name:MICHAEL FRAZIER DPM PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-702-6632
Mailing Address - Street 1:14926 TERRA POINT DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4948
Mailing Address - Country:US
Mailing Address - Phone:713-702-6632
Mailing Address - Fax:833-449-4091
Practice Address - Street 1:21301 KUYKENDAHL RD STE J
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2614
Practice Address - Country:US
Practice Address - Phone:713-702-6632
Practice Address - Fax:833-449-4091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-04
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX386309401Medicaid
TX386309402Medicaid
TX2127OtherPODIATRY LICENSE
TX200048607435OtherCIGNA-PROVIDER NUMBER
TX200048607435OtherCIGNA-PROVIDER NUMBER