Provider Demographics
NPI:1770521924
Name:FRIEDBERG, MICHAEL L (OD, PA)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:FRIEDBERG
Suffix:
Gender:M
Credentials:OD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15920 LEXINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2313
Mailing Address - Country:US
Mailing Address - Phone:281-265-3937
Mailing Address - Fax:281-494-3937
Practice Address - Street 1:15920 LEXINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2313
Practice Address - Country:US
Practice Address - Phone:281-265-3937
Practice Address - Fax:281-494-3937
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2607TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT13337Medicare UPIN
TX8B6529Medicare PIN