Provider Demographics
NPI:1841398294
Name:FRAZIER, JAMES A (CRNA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18104
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-8104
Mailing Address - Country:US
Mailing Address - Phone:409-347-7250
Mailing Address - Fax:
Practice Address - Street 1:1400 HWY 59 LOOP N
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-7807
Practice Address - Country:US
Practice Address - Phone:979-532-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAO04377367500000X
TX714776367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1467383Medicaid
LA4H757Medicare ID - Type Unspecified