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General NPI Number Information
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NPI Number | 1609873587
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Entity Type | Individual
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Provider Name | FREDERICK D WATSON JR. DO
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 2900 NORTH LOOP WEST SUITE 1300
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City | HOUSTON
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State | TX
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Zip | 77092
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Country | US
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Telephone | 832-553-3572
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Fax | 832-553-3402
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Provider Business Mailing Address
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Address Line | 2900 NORTH LOOP WEST SUITE 1300
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City | HOUSTON
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State | TX
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Zip | 77092
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Country | US
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Telephone | 832-553-3572
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Fax | 832-553-3402
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 00686
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200400280
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N0544
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License Number State | TX
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