Provider Demographics
NPI:1134760481
Name:FRIAS-MEDINA, MARIA G
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:G
Last Name:FRIAS-MEDINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 TEXAS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1468
Mailing Address - Country:US
Mailing Address - Phone:281-566-2660
Mailing Address - Fax:281-566-2505
Practice Address - Street 1:2245 TEXAS DR STE 300
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1468
Practice Address - Country:US
Practice Address - Phone:281-566-2660
Practice Address - Fax:281-566-2505
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty