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General NPI Number Information
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NPI Number | 1750337499
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Entity Type | Individual
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Provider Name | JOSE I FREYTES M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 12625 MEMORIAL DR APT 154
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City | HOUSTON
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State | TX
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Zip | 77024-4878
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Country | US
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Telephone | 813-841-7588
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Fax |
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Provider Business Mailing Address
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Address Line | 12625 MEMORIAL DR APT 154
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City | HOUSTON
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State | TX
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Zip | 77024-4878
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Country | US
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Telephone | 813-841-7588
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME95368
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | L7382
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License Number State | TX
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