David K Fry, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

J2568 Issued in TX

Practice address

4311 Wesley St
Greenville, TX 75401-5639

Phone

(903) 455-4458

Fax

(903) 455-1604

NPI assigned

Aug 23, 2005

Last updated

Jul 8, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1114910379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1908",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754031908",
            "telephone_number": "903-454-3025",
            "fax_number": "903-450-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 WESLEY ST",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754015639",
            "telephone_number": "903-455-4458",
            "fax_number": "903-455-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "DAVID",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J2568",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "14506",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "401696YK7L",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130762108",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Kate Freelen, M.S., SLP - INTERN
• Alexandra Marie Freeman, MT-BC
• Timothy Wayne Freer, M.D.
• Christopher French, MD, PHD
• Carolyn Lisa Fry, ACNP-BC,FNP-C, RNFA
• Gail Maxine Fry, LPC
• Trevor Gapare
• Sarah Elizabeth Garcia, FNP-C
• Aleshia Garland, IBCLC
• Kinsey Elise Garner

• Pediatrics Physician in Greenville, TX
• Providers in Greenville, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.