MEDICARE: DR. FREDERICK D WATSON JR. DO

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	207Q00000X	Family Medicine Physician	00686	SC
2	207Q00000X	Family Medicine Physician	200400280	NC
3	207Q00000X	Family Medicine Physician	N0544	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00102353	OTHER		RAILROAD MEDICARE
2	P00115976	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609873587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK D WATSON JR. DO

Provider Business Mailing Address
First Line	:	2900 NORTH LOOP WEST
Second Line	:	SUITE 1300
City	:	HOUSTON
State	:	TX
Zip	:	77092
Country	:	US
Telephone Number	:	832-553-3572
Fax Number	:	832-553-3402

Provider Business Practice Location Address
First Line	:	2900 NORTH LOOP WEST
Second Line	:	SUITE 1300
City	:	HOUSTON
State	:	TX
Zip	:	77092
Country	:	US
Telephone Number	:	832-553-3572
Fax Number	:	832-553-3402

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	02/14/2011

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Directions to “ DR. FREDERICK D WATSON JR. DO” Practice Location

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