Basic Information
Provider Information
NPI: 1629377254
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRAZIER
FirstName: ALARIC
MiddleName: DONHAM
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 721 THOMPSON DR BLDG 577
Address2:  
City: KERRVILLE
State: TX
PostalCode: 780285154
CountryCode: US
TelephoneNumber: 8308962211
FaxNumber:  
Practice Location
Address1: 721 THOMPSON DR BLDG 577
Address2:  
City: KERRVILLE
State: TX
PostalCode: 780285154
CountryCode: US
TelephoneNumber: 8308962211
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/22/2011
LastUpdateDate: 02/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084F0202XA123422CAN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
2084P0800XA123422CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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