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General NPI Number Information
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NPI Number | 1447250659
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Entity Type | Individual
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Provider Name | FREDDIE L CONTRERAS MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 1002 TEXAS BLVD STE 406
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City | TEXARKANA
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State | TX
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Zip | 75501-5113
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Country | US
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Telephone | 903-794-4196
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Fax | 903-792-7408
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Provider Business Mailing Address
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Address Line | P O BOX 9600 DEPT 09-019
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City | TEXARKANA
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State | TX
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Zip | 75505-9600
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Country | US
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Telephone | 903-794-4196
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Fax | 903-792-7408
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | G3244
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | R3788
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License Number State | AR
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