Provider Demographics
NPI:1881958940
Name:FRAZIER, MICHAEL JAMES SR (DPM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JAMES
Last Name:FRAZIER
Suffix:SR
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:J
Other - Last Name:FRAZIER
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:21301 KUYKENDAHL RD STE J
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2614
Mailing Address - Country:US
Mailing Address - Phone:713-702-6632
Mailing Address - Fax:833-449-4091
Practice Address - Street 1:21301 KUYKENDAHL RD STE J
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2614
Practice Address - Country:US
Practice Address - Phone:713-702-6632
Practice Address - Fax:833-449-4091
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2127213ES0103X, 213ES0131X, 213E00000X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX346895101Medicaid
TX346895104Medicaid