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NPI Code Detail

MEDICARE: KELLY J FRASIER M.D.

MEDICARE: KELLY J FRASIER 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
1207W00000XOphthalmology PhysicianM2952TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609894773
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY J FRASIER M.D.
Provider Business Mailing Address
First Line : 350 E INTERSTATE 20
Second Line :
City : ARLINGTON
State : TX
Zip : 76018-1119
Country : US
Telephone Number : 817-784-0222
Fax Number : 817-467-5819
Provider Business Practice Location Address
First Line : 350 E INTERSTATE 20
Second Line :
City : ARLINGTON
State : TX
Zip : 76018-1119
Country : US
Telephone Number : 817-784-0222
Fax Number : 817-467-5819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 04/28/2025

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