Active NPI
Terrance A. Fried, M.D.
- Nephrology Physician
- San Antonio, TX
National Provider Identifier
1154305787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- F3128
- Practice address
- 1008 Brooklyn Ave
San Antonio, TX 78215-1617 - Phone
- (210) 228-0743
- Fax
- (210) 228-9749
- NPI assigned
- Dec 6, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | F3128 | TX | Primary |
Addresses
Primary practice location
1008 Brooklyn Ave
San Antonio, TX 78215-1617
Mailing address
7142 San Pedro Ave
Suite 120
San Antonio, TX 78216-6256
Phone (210) 661-5622
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125760201 | Medicaid | TX | |
| 390003679 | Other | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F3128 | TX | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1154305787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7142 SAN PEDRO AVE",
"address_2": "SUITE 120",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782166256",
"telephone_number": "210-661-5622",
"fax_number": "210-395-4012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 BROOKLYN AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782151617",
"telephone_number": "210-228-0743",
"fax_number": "210-228-9749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIED",
"first_name": "TERRANCE",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TX",
"license": "F3128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125760201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "390003679",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.