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NPI Code Detail

MEDICARE: DR. ROBERT LEE FRAZER JR. D.D.S.

MEDICARE: DR. ROBERT LEE FRAZER JR. D.D.S.
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
11223G0001XGeneral Practice Dentistry9313TX

General Provider Information

NPI Number : 1942419932
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT LEE FRAZER JR. D.D.S.
Provider Business Mailing Address
First Line : 9702 SORRENTO CT
Second Line :
City : AUSTIN
State : TX
Zip : 78759-5611
Country : US
Telephone Number : 512-345-3667
Fax Number :
Provider Business Practice Location Address
First Line : 8118 SHOAL CREEK BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78757-8041
Country : US
Telephone Number : 512-452-8262
Fax Number : 512-420-8265
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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