Provider Demographics
NPI:1205657038
Name:FRYAR, THOMAS (MED)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:FRYAR
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 WILLOWBY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3060
Mailing Address - Country:US
Mailing Address - Phone:832-794-2273
Mailing Address - Fax:
Practice Address - Street 1:3131 EASTSIDE ST STE 415
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1919
Practice Address - Country:US
Practice Address - Phone:281-948-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95276101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health