Provider Demographics
NPI:1215340781
Name:FRITZ, BRAXTON (MD)
Entity type:Individual
Prefix:
First Name:BRAXTON
Middle Name:
Last Name:FRITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:11820 BANDERA RD STE 102
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4637
Practice Address - Country:US
Practice Address - Phone:210-477-7180
Practice Address - Fax:210-736-7072
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01081892A207Q00000X
SC36970207Q00000X
TXU8632207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine