Healthcare Provider Details

I. General information

NPI: 1649264656
Provider Name (Legal Business Name): JAMES E FROELICH III D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 N CENTER ST
BONHAM TX
75418-2627
US

IV. Provider business mailing address

2105 N CENTER ST
BONHAM TX
75418-2627
US

V. Phone/Fax

Practice location:
  • Phone: 903-583-3191
  • Fax: 903-583-3973
Mailing address:
  • Phone: 903-583-3191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF9452
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: