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NPI Code Detail

MEDICARE: DR. CAROLYN SUE FRUTHALER M.D.

MEDICARE: DR. CAROLYN SUE FRUTHALER 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
1207V00000XObstetrics & Gynecology PhysicianH2123TX

General Provider Information

NPI Number : 1609892991
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROLYN SUE FRUTHALER M.D.
Provider Business Mailing Address
First Line : 2223 WEST LOOP S
Second Line :
City : HOUSTON
State : TX
Zip : 77027-3588
Country : US
Telephone Number : 713-439-6139
Fax Number :
Provider Business Practice Location Address
First Line : 2223 WEST LOOP S
Second Line :
City : HOUSTON
State : TX
Zip : 77027-3588
Country : US
Telephone Number : 713-439-6139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 07/11/2007

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