Basic Information
Provider Information
NPI: 1386831246
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRIEDMAN
FirstName: TERESA
MiddleName: ANNE
NamePrefix: DR.
NameSuffix:  
Credential: D.O
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 36000 DARNALL LOOP
Address2: CARL R. DARNALL ARMY MEDICAL CENTER
City: FORT HOOD
State: TX
PostalCode: 76544
CountryCode: US
TelephoneNumber: 2542888302
FaxNumber: 2542867055
Practice Location
Address1: 36000 DARNALL LOOP
Address2: CARL R. DARNALL ARMY MEDICAL CENTER
City: FORT HOOD
State: TX
PostalCode: 76544
CountryCode: US
TelephoneNumber: 2542888302
FaxNumber: 2542867055
Other Information
ProviderEnumerationDate: 09/25/2007
LastUpdateDate: 07/09/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X20A10814CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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