Provider Demographics
NPI:1487702825
Name:FRIED, GABRIEL (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:FRIED
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13740 MIDWAY RD
Mailing Address - Street 2:SUITE 610
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4314
Mailing Address - Country:US
Mailing Address - Phone:972-361-0155
Mailing Address - Fax:972-361-0151
Practice Address - Street 1:13740 MIDWAY RD
Practice Address - Street 2:SUITE 610
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4314
Practice Address - Country:US
Practice Address - Phone:972-361-0155
Practice Address - Fax:972-361-0151
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD9796207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC15778Medicare UPIN