MEDICARE: WILLIAM JEFFREY FRACE, 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
1	207L00000X	Anesthesiology Physician	F6634	TX

General Provider Information

NPI Number	:	1285688382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM JEFFREY FRACE, M.D.

Provider Business Mailing Address
First Line	:	PO BOX 73265
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77273-3265
Country	:	US
Telephone Number	:	281-580-9030
Fax Number	:	281-580-2725

Provider Business Practice Location Address
First Line	:	12727 KIMBERLEY LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4047
Country	:	US
Telephone Number	:	281-580-9030
Fax Number	:	281-580-2725

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	IRENE FONTENOT
Credential	:
Telephone Number	:	281-580-9030

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/22/2020

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