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General NPI Number Information
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NPI Number | 1114066081
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Entity Type | Individual
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Provider Name | CAREY R FRACHT O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 03/20/2020
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Provider Practice Location Address
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Address Line | 130 N AUSTIN ST
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City | JASPER
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State | TX
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Zip | 75951-4102
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Country | US
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Telephone | 409-384-5192
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Fax |
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Provider Business Mailing Address
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Address Line | 130 N AUSTIN ST
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City | JASPER
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State | TX
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Zip | 75951-4102
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Country | US
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Telephone | 409-384-5192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2833T
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License Number State | TX
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