MR. Ronald Derald Fryar JR., IDC

NPI #1700090685 in Ingleside, Texas

Provider Information

NPI Number: 1700090685
Entity Type: Individual
Name: MR. Ronald Derald Fryar JR., IDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Military Health Care Provider - Independent Duty Corpsman
Credential: IDC
Enumeration Date: May 9, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1451 LEXINGTON DRIVE
City: Ingleside
State: Texas
ZIP Code: 78362
Phone: (361) 776-4077

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman	1710I1002X	Primary

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