MEDICARE: BRITNEY RAYE FRIES PT

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	208100000X	Physical Medicine & Rehabilitation Physician	1182955	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1182955	OTHER	TX	PHYSICAL THERAPY

General Provider Information

NPI Number	:	1437471182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITNEY RAYE FRIES PT

Provider Business Mailing Address
First Line	:	6705 W HWY 290
Second Line	:	SUITE C-1
City	:	AUSTIN
State	:	TX
Zip	:	78735-8400
Country	:	US
Telephone Number	:	512-892-7200
Fax Number	:	512-892-7205

Provider Business Practice Location Address
First Line	:	2621 RIDGEPOINT DR
Second Line	:	SUITE 140
City	:	AUSTIN
State	:	TX
Zip	:	78754-5232
Country	:	US
Telephone Number	:	512-744-6025
Fax Number	:	512-926-7475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	02/23/2010

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Directions to “ BRITNEY RAYE FRIES PT” Practice Location

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