Basic Information
| Provider Information | |||||||||
| NPI: | 1922016013 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLIEDNER | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 328 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEWISVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750573866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724367557 | ||||||||
| FaxNumber: | 9722218246 | ||||||||
| Practice Location | |||||||||
| Address1: | 328 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LEWISVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750573866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724367557 | ||||||||
| FaxNumber: | 9722218246 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 02/14/2013 | ||||||||
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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 | 207V00000X | J4118 | TX | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 042959903 | 05 | TX | MEDICAID | 042959902 | 05 | TX | MEDICAID | 8BJ296 | 01 | TX | BCBS | OTHER | 042959901 | 05 | TX | MEDICAID |