Organization Active NPI

Freedom Therapeutics

  • General Practice Physician
  • Shenandoah, TX
National Provider Identifier
1932644556
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FREEDOM THERAPEUTICS
Practice address
129 Vision Park Blvd Ste 211B
Shenandoah, TX 77384-3024
Phone
(936) 273-5214
NPI assigned
Jan 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Cheri Grantham
Title
Owner
Phone
(936) 524-3428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

129 Vision Park Blvd Ste 211B
Shenandoah, TX 77384-3024

Mailing address

12743 Virgo Dr
Willis, TX 77318-5250
Phone (936) 524-3428

Other practice location 1

12743 Virgo Dr
Willis, TX 77318-5250
Phone (936) 524-3428

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1932644556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12743 VIRGO DR",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185250",
            "telephone_number": "936-524-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 VISION PARK BLVD STE 211B",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843024",
            "telephone_number": "936-273-5214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12743 Virgo Dr",
            "address_purpose": "LOCATION",
            "city": "Willis",
            "state": "TX",
            "postal_code": "773185250",
            "country_code": "US",
            "telephone_number": "936-524-3428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREEDOM THERAPEUTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-524-3428"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.