MEDICARE: DR. JOHN FREY MD

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	207P00000X	Emergency Medicine Physician	E-10044	AR
2	207P00000X	Emergency Medicine Physician	G77222	CA
3	207P00000X	Emergency Medicine Physician	L4943	TX

General Provider Information

NPI Number	:	1811998453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN FREY MD

Provider Business Mailing Address
First Line	:	2801 RICHMOND RD.
Second Line	:	#31
City	:	TEXARKANA
State	:	TX
Zip	:	75503
Country	:	US
Telephone Number	:	903-276-5971
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 RICHMOND RD
Second Line	:	#31
City	:	TEXARKANA
State	:	TX
Zip	:	75503-2123
Country	:	US
Telephone Number	:	903-276-5971
Fax Number	:

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

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	04/17/2023

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Directions to “ DR. JOHN FREY MD” Practice Location

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