Individual provider Active NPI

William A Fridley, M.D.

  • Internal Medicine Physician
  • Shenandoah, TX
National Provider Identifier
1760456545
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
J7961 Issued in TX
Practice address
9201 Pinecroft Dr Ste 200
Shenandoah, TX 77380-3889
Phone
(281) 863-9554
Fax
(832) 246-8925
NPI assigned
Feb 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X J7961 TX Primary

Addresses

Primary practice location

9201 Pinecroft Dr Ste 200
Shenandoah, TX 77380-3889

Mailing address

9201 Pinecroft Dr Ste 200
Shenandoah, TX 77380-3889
Phone (281) 863-9554

Other identifiers 3

IdentifierTypeStateIssuer
096695403MedicaidTX
8B8661OtherTXBCBS OF TEXAS
096695404MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031104000209 TX Practitioner - Internal Medicine 3870405376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10970 Shadow Creek Pkwy
Suite 100
Pearland, TX 77584-0166
Phone (281) 398-8500

134 Vision Park Blvd
Shenandoah, TX 77384-3032

17450 St Lukes Way
Suite 230
The Woodlands, TX 77384-8045
Phone (832) 334-7756

17510 W Grand Pkwy S
Sugar Land, TX 77479-2649

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Jun 17, 2024 Accepting new patients
Privia Medical Group Gulf Coast PLLC CurrentSince Jun 17, 2024 Accepting new patients
Woodlands Diagnostic Clinic, PA CurrentSince Sep 30, 2020 Accepting new patients
Southwest Texas Two Medical Group, PLLC Past Accepting new patients
Family Healthcare Affiliates PLLC PastSince Aug 13, 2002 Accepting new patients

Locations

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

1200 Binz St
Ste 1490
Houston, TX 77004
Phone (713) 512-7027

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

9201 Pinecroft Dr
Shenandoah, TX 77380
Phone (832) 246-8000

9201 Pinecroft Dr
Ste 200
Shenandoah, TX 77380
Phone (281) 394-4704

134 Vision Park Blvd
Ste 300
Shenandoah, TX 77384
Phone (281) 296-8500

8845 Six Pines Dr
Fl 2
Shenandoah, TX 77380
Phone (281) 367-3343

2255 E Mossy Oaks Rd
Ste 500
Spring, TX 77389
Phone (832) 232-5658

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

9303 Pinecroft Dr
Ste 340
The Woodlands, TX 77380
Phone (281) 681-0616

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: william.fridley.1@8042.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1760456545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 PINECROFT DR STE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803889",
            "telephone_number": "281-863-9554",
            "fax_number": "832-246-8925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 PINECROFT DR STE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803889",
            "telephone_number": "281-863-9554",
            "fax_number": "832-246-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDLEY",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "J7961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096695403",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8B8661",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096695404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.