Provider Demographics
NPI:1346356201
Name:FRIESENHAHN, GERLYN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:GERLYN
Middle Name:MARIE
Last Name:FRIESENHAHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8711 VILLAGE DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5418
Mailing Address - Country:US
Mailing Address - Phone:830-201-0500
Mailing Address - Fax:830-201-0502
Practice Address - Street 1:545 CREEKSIDE XING
Practice Address - Street 2:SUITE 106
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4271
Practice Address - Country:US
Practice Address - Phone:830-201-0500
Practice Address - Fax:830-201-0502
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH23852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE43736Medicare UPIN
TX0079EJOtherBC/BS
TXE43736Medicare UPIN
TN130025478OtherRR MEDICARE
TX00581LMedicare ID - Type Unspecified
TX3243736OtherBLUELINK
TX0306540-01Medicaid