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General NPI Number Information
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NPI Number | 1528829637
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Entity Type | Individual
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Provider Name | CLYDE FRALEY LMFT
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Gender | Male
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Dates
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Enumeration Date | 01/17/2024
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 1110 N LOOP 336 W STE 430A
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City | CONROE
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State | TX
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Zip | 77301-1193
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Country | US
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Telephone | 936-217-4264
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Fax |
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Provider Business Mailing Address
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Address Line | 320 RIVUS OVERLOOK DR
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City | WILLIS
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State | TX
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Zip | 77318-1212
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Country | US
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Telephone | 936-217-4264
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 203587
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License Number State | TX
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