RONALD DERALD FRYAR

INGLESIDE, TX
NPI1700090685
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2007-05-09
Last Update Date2007-07-08
Business Address
Mr. RONALD DERALD FRYAR IDC
1451 LEXINGTON DRIVE
INGLESIDE, TX 78362
Phone number: 361-776-4077
Mailing Address
Mr. RONALD DERALD FRYAR IDC
1130 LA MIRADA
PORTLAND, TX 78374-4133
Phone number: 361-643-5833