NPIMap

Organization Active NPI

Charles T Fries Edd PC

  • Psychologist
  • Tyler, TX
National Provider Identifier
1831227909
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
21305 Issued in TX
Legal business name
CHARLES T FRIES EDD PC
Practice address
3800 Paluxy Dr
Suite 440
Tyler, TX 75703
Phone
(903) 526-5550
Fax
(903) 526-5551
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Charles T Fries, EDDNPI 1003970625
Title
President Charles T Fries Edd PC
Phone
(903) 526-5550

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 19298 TX
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 17645 TX
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 21305 TX Primary

Addresses

Primary practice location

3800 Paluxy Dr
Suite 440
Tyler, TX 75703

Mailing address

3800 Paluxy Dr
Suite 440
Tyler, TX 75703
Phone (903) 526-5550

Other identifiers 2

IdentifierTypeStateIssuer
84575LOtherTXBLUE CROSS BLUE SHIELD JU
81478POtherTXBLUE CROSS BLUE SHIELD CH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120206000230 TX Part B Supplier - Clinic/Group Practice 3779740600 Receives reassigned benefits from 1 practitioner
Practice locations: Tyler, TX

National Provider Directory

National Provider Directory

Locations

3800 Paluxy Dr
Ste 440
Tyler, TX 75703
Phone (903) 526-5550

Practitioners & affiliated clinicians

Practitioners 5

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": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1831227909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PALUXY DR",
            "address_2": "SUITE 440",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-526-5550",
            "fax_number": "903-526-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PALUXY DR",
            "address_2": "SUITE 440",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75703",
            "telephone_number": "903-526-5550",
            "fax_number": "903-526-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES T FRIES EDD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FRIES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT CHARLES T FRIES EDD PC",
        "authorized_official_telephone_number": "903-526-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "19298",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "17645",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "21305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD JU",
            "identifier": "84575L",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD CH",
            "identifier": "81478P",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.