MEDICARE: KAYCE A FRYE

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
1	111N00000X	Chiropractor	5449	TX
2	363LF0000X	Family Nurse Practitioner	F0914439	TX

General Provider Information

NPI Number	:	1225431091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAYCE A FRYE

Provider Business Mailing Address
First Line	:	17655 HENDERSON PASS APT 816
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-1547
Country	:	US
Telephone Number	:	956-763-7767
Fax Number	:

Provider Business Practice Location Address
First Line	:	17655 HENDERSON PASS APT 816
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-1547
Country	:	US
Telephone Number	:	956-763-7767
Fax Number	:

Authorized Official
Title or Position	:	FNP/CHIROPRACTOR/OWNER
Name	:	DR. KAYCE ANN FRYE
Credential	:	F.N.P., D.C.
Telephone Number	:	956-763-7767

Provider Enumeration Date	:	10/07/2014
Last Update Date	:	04/14/2015

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