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General NPI Number Information
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NPI Number | 1942314406
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Entity Type | Individual
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Provider Name | CLIFFORD JACK FRAIM M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 1600 W 38TH ST STE 308
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City | AUSTIN
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State | TX
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Zip | 78731-6406
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Country | US
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Telephone | 512-324-3580
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Fax | 512-324-3581
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Provider Business Mailing Address
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Address Line | 1400 N IH 35 STE 300
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City | AUSTIN
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State | TX
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Zip | 78701-1926
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Country | US
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Telephone | 512-324-8300
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Fax | 512-324-8301
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | E4337
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License Number State | TX
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