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NPI Code Detail

MEDICARE: DR. STEPHEN HOWARD FRYE M.D.

MEDICARE: DR. STEPHEN HOWARD FRYE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor9427NV
22084P0800XPsychiatry Physician9427NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NONEOTHERNVNONE

General Provider Information

NPI Number : 1164755328
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN HOWARD FRYE M.D.
Provider Business Mailing Address
First Line : 2108 PLAZA DEL PADRE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-3979
Country : US
Telephone Number : 775-885-7300
Fax Number :
Provider Business Practice Location Address
First Line : 3441 W SAHARA AVE STE C1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-6059
Country : US
Telephone Number : 702-445-7318
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2009
Last Update Date : 02/18/2026

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