Provider Demographics
NPI:1528262185
Name:FRIDLINGTON, EMILY KIM (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KIM
Last Name:FRIDLINGTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W SUNSET RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2797
Mailing Address - Country:US
Mailing Address - Phone:210-255-8447
Mailing Address - Fax:210-255-8446
Practice Address - Street 1:131 W SUNSET RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2797
Practice Address - Country:US
Practice Address - Phone:210-255-8447
Practice Address - Fax:210-255-8446
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA37782207N00000X
TXBP10026398207RA0000X
TXP2644207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3864783101OtherMYUTMB 3864783101-COMMERCIAL NUMBER