Provider Demographics
NPI:1831127620
Name:BRESSLER, FRED JAY (MD)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:JAY
Last Name:BRESSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 1703
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2732
Mailing Address - Country:US
Mailing Address - Phone:713-441-3223
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 1703
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2732
Practice Address - Country:US
Practice Address - Phone:713-441-3223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9304207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H9304OtherSTATE LIC
760388511OtherTAX ID
TX00K65FOtherBLUE CROSS/BLUE SHIELD TX
TX099172103Medicaid
TX099172102Medicaid
H9304OtherSTATE LIC
TX099172103Medicaid