MEDICARE: LAURA KATHLEEN FRYE MD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	72130	WI
2	207RP1001X	Pulmonary Disease Physician	W2847	TX
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	W2847	TX
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	12603523-1205	UT
5	207RP1001X	Pulmonary Disease Physician	12603523-1205	UT
6	207RP1001X	Pulmonary Disease Physician	72130	WI

General Provider Information

NPI Number	:	1518197417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA KATHLEEN FRYE MD

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6202 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75325
Country	:	US
Telephone Number	:	214-645-3999
Fax Number	:

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

Provider Enumeration Date	:	07/26/2009
Last Update Date	:	04/14/2026

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