Provider Demographics
NPI:1902898612
Name:FRIEDMAN, RONALD MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MICHAEL
Last Name:FRIEDMAN
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:PO BOX 866365
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6365
Mailing Address - Country:US
Mailing Address - Phone:469-467-0100
Mailing Address - Fax:469-467-0105
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:BUILDING 3, SUITE 232
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8122
Practice Address - Country:US
Practice Address - Phone:469-467-0100
Practice Address - Fax:469-467-0105
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9515174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00033ADMedicare ID - Type Unspecified
TXF92658Medicare UPIN