Provider Demographics
NPI:1154360923
Name:FREEMYER, VINCENT C (DO)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:C
Last Name:FREEMYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7924 OLD MCGREGOR RD
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3840
Mailing Address - Country:US
Mailing Address - Phone:254-292-3232
Mailing Address - Fax:
Practice Address - Street 1:980 E KNIGHTS WAY STE 100
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-7198
Practice Address - Country:US
Practice Address - Phone:254-277-1459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7198207PE0004X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187321801Medicaid
TX8AN320OtherBCBSTX
TX187321801Medicaid