Fred A Quenzer Jr., M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

D2569 Issued in TX

Practice address

1002 Live Oak LN
Taylor Lake Village, TX 77586-4527

Phone

(832) 563-8054

Fax

(281) 326-4701

NPI assigned

Oct 17, 2005

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

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": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1114916723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 LIVE OAK LN",
            "city": "TAYLOR LAKE VILLAGE",
            "state": "TX",
            "postal_code": "775864527",
            "telephone_number": "832-563-8054",
            "fax_number": "281-326-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 LIVE OAK LN",
            "city": "TAYLOR LAKE VILLAGE",
            "state": "TX",
            "postal_code": "775864527",
            "telephone_number": "832-563-8054",
            "fax_number": "281-326-4701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Garth Rd",
            "address_purpose": "LOCATION",
            "city": "Baytown",
            "state": "TX",
            "postal_code": "775212122",
            "country_code": "US",
            "telephone_number": "281-359-7788",
            "fax_number": "281-359-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUENZER",
        "first_name": "FRED",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "D2569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132532601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Jean Chapman, CRNA
• Eleanore Jane Scott, MT-BC

• Diagnostic Radiology Physician in Taylor Lake Village, TX
• Providers in Taylor Lake Village, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.