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Dr. Robert W Frederick, MD
Urology Physician in Longview, Texas
NPI 1780658112

Robert W Frederick is a Urology Physician based in Dallas, TX. Robert W Frederick practices in Longview, TX and has the professional credentials of MD. The NPI Number for Robert W Frederick is 1780658112 and holds a License No. K7155 (Texas).

The current practice location address for Robert W Frederick is 703 E Marshall Ave Ste 5007, Longview, TX and can be reached out via phone at 903-315-4455 and via fax at 903-315-2466.

Location: 703 E Marshall Ave Ste 5007, Longview, TX, 75284-6098
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780658112
Provider Name
Robert W Frederick
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
703 E Marshall Ave Ste 5007, Longview, TX, 75284-6098
Phone Number
903-315-4455
Fax Number
903-315-2466
Provider Enumeration Date
02/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
145418306 05 TX
145418307 05 TX
75-2616977-007 01 TX TRICARE-DOUGLAS
752616977029 01 TX TRICARE ATHENS LOCATION
75-2616977-126 01 TX TRICARE
75-2616977-029 01 TX TRICARE
145418308 05 TX
institution
Provider Business Practice Location Address Details
Address
703 E Marshall Ave Ste 5007
City
Longview
State
Texas
Zip
75601
Phone Number
903-315-4455
Fax Number
903-315-2466
person
Provider Business Mailing Address Details
Address
703 E Marshall Ave Ste 5007
City
Longview
State
Texas
Zip
75601
Phone Number
903-315-4455
Fax Number
903-315-2466
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
208800000X
License No.
K7155 (Texas)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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