Provider Demographics
NPI:1780656165
Name:FRY, LON ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:LON
Middle Name:ALAN
Last Name:FRY
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Gender:M
Credentials:DO
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Mailing Address - Street 1:203 TOPHILL RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3443
Mailing Address - Country:US
Mailing Address - Phone:210-824-6986
Mailing Address - Fax:210-292-7986
Practice Address - Street 1:BROOKE ARMY MEDICAL CENTER
Practice Address - Street 2:3551 ROGER BROOKE DRIVE
Practice Address - City:JBSA FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-6705
Practice Address - Fax:210-916-8712
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2020-05-10
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Provider Licenses
StateLicense IDTaxonomies
TXK1196207LP3000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology