Provider Demographics
NPI:1649264656
Name:FROELICH, JAMES E III (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:FROELICH
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418-2627
Mailing Address - Country:US
Mailing Address - Phone:903-583-3191
Mailing Address - Fax:
Practice Address - Street 1:2105 N CENTER ST
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-2627
Practice Address - Country:US
Practice Address - Phone:903-583-3191
Practice Address - Fax:903-583-3973
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9452207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100018401Medicaid
TXD97334Medicare UPIN
TX100018401Medicaid