MEDICARE: DR. REID NATHANIEL FRAZIER DPT

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1477018760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REID NATHANIEL FRAZIER DPT

Provider Business Mailing Address
First Line	:	6011 CHARRINGTON DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-2933
Country	:	US
Telephone Number	:	713-385-2840
Fax Number	:

Provider Business Practice Location Address
First Line	:	2035 FORT WORTH HWY
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-4782
Country	:	US
Telephone Number	:	817-599-9271
Fax Number	:

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

Provider Enumeration Date	:	01/31/2019
Last Update Date	:	01/31/2019

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