Healthcare Provider Details

I. General information

NPI: 1881958940
Provider Name (Legal Business Name): MICHAEL JAMES FRAZIER SR. DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL J FRAZIER SR. DPM

II. Dates (important events)

Enumeration Date: 07/03/2012
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 ED ENGLISH DR STE A
SHENANDOAH TX
77385-8023
US

IV. Provider business mailing address

255 ED ENGLISH DR STE A
SHENANDOAH TX
77385-8023
US

V. Phone/Fax

Practice location:
  • Phone: 713-702-6632
  • Fax: 833-449-4091
Mailing address:
  • Phone: 713-702-6632
  • Fax: 833-449-4091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number2127
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number2127
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2127
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number2127
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2127
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: