Provider Demographics
NPI:1669582888
Name:FRIERSON-STROUD, LEONOR B (MD)
Entity type:Individual
Prefix:
First Name:LEONOR
Middle Name:B
Last Name:FRIERSON-STROUD
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:PO BOX 28369
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-8369
Mailing Address - Country:US
Mailing Address - Phone:512-338-0171
Mailing Address - Fax:512-338-0771
Practice Address - Street 1:8000 ANDERSON SQ STE 113
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-8482
Practice Address - Country:US
Practice Address - Phone:512-338-0171
Practice Address - Fax:512-338-0771
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2384207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB106048Medicare UPIN
TXTXB106048Medicare PIN
E04587Medicare UPIN
00823MMedicare ID - Type Unspecified