MEDICARE: FRED E GRIFFITHS

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1609821719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRED E GRIFFITHS

Provider Business Mailing Address
First Line	:	6200 READVILL COURT
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78739
Country	:	US
Telephone Number	:	512-288-0859
Fax Number	:	512-301-4821

Provider Business Practice Location Address
First Line	:	6200 READVILL CT
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78739-1703
Country	:	US
Telephone Number	:	512-288-0859
Fax Number	:	512-301-4821

Authorized Official
Title or Position	:	OWNER
Name	:	FRED E GRIFFITHS
Credential	:	M.D.
Telephone Number	:	512-288-0859

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	05/27/2008

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Directions to “FRED E GRIFFITHS ” Practice Location

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