MEDICARE: JOHN HOWARD FRIERSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	G3371	TX
2	207RI0011X	Interventional Cardiology Physician	G3371	TX
3	207R00000X	Internal Medicine Physician	G3371	TX

General Provider Information

NPI Number	:	1326021015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN HOWARD FRIERSON M.D.

Provider Business Mailing Address
First Line	:	1200 BROOKLYN AVE
Second Line	:	STE 120
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-4816
Country	:	US
Telephone Number	:	210-271-7266
Fax Number	:	210-226-8411

Provider Business Practice Location Address
First Line	:	1200 BROOKLYN AVE
Second Line	:	STE 120
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-4816
Country	:	US
Telephone Number	:	210-271-7266
Fax Number	:	210-226-8411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	03/29/2022

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