Provider Demographics
NPI:1710975560
Name:FROESCHKE, HARRY P (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:P
Last Name:FROESCHKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 E MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5602
Mailing Address - Country:US
Mailing Address - Phone:903-758-2610
Mailing Address - Fax:903-758-7081
Practice Address - Street 1:705 E MARSHALL AVE STE 3000
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5661
Practice Address - Country:US
Practice Address - Phone:903-758-2610
Practice Address - Fax:903-758-2610
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7809207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099811402Medicaid
TX099811402Medicaid
TX88W491Medicare PIN