| Dr David K Fry, MD | |
|
4311 Wesley St, Greenville, TX 75401-5639 | |
| (903) 455-4458 | |
| (903) 455-1604 |
| Full Name | Dr David K Fry |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 4311 Wesley St, Greenville, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114910379 | NPI | - | NPPES |
| 130762108 | Medicaid | TX | |
| 401696YK7L | Other | TX | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | J2568 (Texas) | Primary |
| 208000000X | Pediatrics | 14506 (Nebraska) | Secondary |
| Entity Name | Community Health Service Agency, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700067253 PECOS PAC ID: 6305735150 Enrollment ID: O20040612000279 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David K Fry, MD Po Box 1908, Greenville, TX 75403-1908 Ph: (903) 454-3025 | Dr David K Fry, MD 4311 Wesley St, Greenville, TX 75401-5639 Ph: (903) 455-4458 |
Kristi Whitenton, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 3005 Joe Ramsey Blvd E, Greenville, TX 75401 Phone: 903-455-4458 Fax: 903-455-1604 | |
Dr. Barry L Justice, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5101 Wellington St Unit C, Greenville, TX 75402 Phone: 903-455-3261 Fax: 903-455-0211 | |
Dr. Amardeep K Sandhu, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4211 Joe Ramsey Blvd E Ste 213, Greenville, TX 75401 Phone: 903-408-7780 Fax: 903-408-7840 | |
Dr. Lori Renee Allembaugh, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 5101 Wellington St Unit C, Greenville, TX 75402 Phone: 903-455-3261 Fax: 903-455-0211 | |
Alison Sajan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4400 I 30 W Ste 110, Greenville, TX 75402 Phone: 469-800-3600 | |
Dr. Patrice A Patterson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5101 Wellington St Unit C, Greenville, TX 75402 Phone: 903-455-3261 Fax: 903-455-0211 |