Gary Stewart Fries, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

17713 Issued in TX

Practice address

111 Professional Park Dr
Victoria, TX 77904-2351

Phone

(361) 578-0247

Fax

(361) 578-0240

NPI assigned

Jan 9, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2015 through Jul 1, 2027

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Victoria Oral & Maxillofacial Surgery Associates Inc,

  • Oral and Maxillofacial Surgery (Dentist)
  • Victoria, TX
  • NPI 1417002171
  NPD
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396894515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-578-0247",
            "fax_number": "361-578-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PROFESSIONAL PARK DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042351",
            "telephone_number": "361-578-0247",
            "fax_number": "361-578-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES",
        "first_name": "GARY",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "17713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007936001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick B Niegos Mdpa
• Frederick F Lykes, M D P a
• Ray M Freeman, DC
• Frels Orthodontics PLLC (Leslie K. Frels, D.D.S., M.S.D.)
• Leslie Frels, DDS
• Elizabeth Frietsch, LPC
• Frio Hospital District (Retama Manor Nursing Center/Victoria South)
• Virginia Frnka, LPC
• Fred M. Fry, M.D.
• Vanessa Fuson Wagster

• Oral and Maxillofacial Surgery (Dentist) in Victoria, TX
• Providers in Victoria, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.