MEDICARE: DR. CAREN RAE GERTNER FRITTS PH.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
1	103T00000X	Psychologist	34015	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1760640783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAREN RAE GERTNER FRITTS PH.D

Provider Business Mailing Address
First Line	:	4502 SPELLMAN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-6022
Country	:	US
Telephone Number	:	713-253-2492
Fax Number	:	936-653-3787

Provider Business Practice Location Address
First Line	:	4502 SPELLMAN RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77035-6022
Country	:	US
Telephone Number	:	713-253-2492
Fax Number	:	936-653-3787

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

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	06/14/2021

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