Charles T Fries, EDD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

21305 Issued in TX

Practice address

3800 Paluxy Dr
Suite 440
Tyler, TX 75703

Phone

(903) 526-5550

Fax

(903) 526-5551

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Charles T Fries Edd PC

  • Psychologist
  • Tyler, TX
  • NPI 1831227909
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003970625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PALUXY DR",
            "address_2": "SUITE 440",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-526-5550",
            "fax_number": "903-526-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PALUXY DR",
            "address_2": "SUITE 440",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-526-5550",
            "fax_number": "903-526-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES",
        "first_name": "CHARLES",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "EDD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "21305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "81478P",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Xavier French, DO
• Wade E French, ED.D., LPC
• Fresh Dental PLLC
• Lori Ann Fried, FNP-C
• Jessica Friend
• Barry Frizzell, LAT, ATC, PTA, CSCS
• Tyson Frodsham
• Keren Naomi Fuentes Marin
• Laura Fuentes
• Nayeli Fuentes, MD

• Psychologist in Tyler, TX
• Providers in Tyler, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.