Healthcare Provider Details

I. General information

NPI: 1447442165
Provider Name (Legal Business Name): MATTHEW HARVEY FRIEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 02/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 W. ILLINOIS AVE
MIDLAND TX
79707
US

IV. Provider business mailing address

PO BOX 8146
TYLER TX
75711-8146
US

V. Phone/Fax

Practice location:
  • Phone: 432-683-3206
  • Fax:
Mailing address:
  • Phone: 800-288-8325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberN5060
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: