Basic Information
| Provider Information | |||||||||
| NPI: | 1124034293 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRITZ | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | ANTHONY | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 905 CRESCENT DR | ||||||||
| Address2: | |||||||||
| City: | BELTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765136723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547801453 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1901 S 1ST ST | ||||||||
| Address2: | |||||||||
| City: | TEMPLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765047451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547430963 | ||||||||
| FaxNumber: | 7257430137 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1600 | TX | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.