Organization Active NPI

Fry Road Pediatrics P.a

  • Pediatrics Physician
  • Katy, TX
National Provider Identifier
1790018331
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FRY ROAD PEDIATRICS P.A
Practice address
21372 Provincial Blvd
Katy, TX 77450-7580
Phone
(281) 578-9766
Fax
(281) 578-6540
NPI assigned
Sep 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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

Authorized official

Name
Ifthekar Unnissa, MDNPI 1265443493
Title
President
Phone
(281) 578-9766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

21372 Provincial Blvd
Katy, TX 77450-7580

Mailing address

21372 Provincial Blvd
Katy, TX 77450-7580
Phone (281) 578-9766

National Provider Directory

National Provider Directory

Locations

21372 Provincial Blvd
Katy, TX 77450
Phone (281) 578-9766

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252972800000",
    "number": "1790018331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21372 PROVINCIAL BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-578-9766",
            "fax_number": "281-578-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21372 PROVINCIAL BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-578-9766",
            "fax_number": "281-578-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRY ROAD PEDIATRICS P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A",
        "authorized_official_last_name": "UNNISSA",
        "authorized_official_first_name": "IFTHEKAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-578-9766",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.