MEDICARE: LIAM MCCOY FRY MD

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	207R00000X	Internal Medicine Physician	M3553	TX
2	207R00000X	Internal Medicine Physician	13339	HI
3	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	M3553	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00373885	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8W4930	OTHER	TX	BCBS OF TEXAS

General Provider Information

NPI Number	:	1952322570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIAM MCCOY FRY MD

Provider Business Mailing Address
First Line	:	1108 LAVACA ST
Second Line	:	SUITE 110-320
City	:	AUSTIN
State	:	TX
Zip	:	78701-2172
Country	:	US
Telephone Number	:	512-477-4088
Fax Number	:	512-482-0390

Provider Business Practice Location Address
First Line	:	1108 LAVACA ST
Second Line	:	SUITE 110-320
City	:	AUSTIN
State	:	TX
Zip	:	78701-2172
Country	:	US
Telephone Number	:	512-477-4088
Fax Number	:	512-482-0390

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	11/18/2025

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Directions to “ LIAM MCCOY FRY MD” Practice Location

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