FREDERICKSBURG CLINIC PLLC NPI 1033145545

NPI Information

  • NPI: 1033145545
  • Provider Name: FREDERICKSBURG CLINIC, PLLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 45D0504078
  • Address: 1308 SOUTH HIGHWAY 16
    FREDERICKSBURG, TX
    ZIP 78624
  • Phone: (830) 997-2181

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NPI Details

FREDERICKSBURG CLINIC, PLLC is a family medicine in Fredericksburg, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FREDERICKSBURG CLINIC, PLLC NPI is 1033145545. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1308 SOUTH HIGHWAY 16
FREDERICKSBURG, TX
ZIP 78624-058
Phone: (830) 997-2181
Fax: (830) 997-9598

The provider's authorized official is John Radcliffe Kothmann .
The authorized official title is Authorized Official and has the following contact phone number (830) 997-2181.

The CLIA number assigned to this NPI record is 45D0504078 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 11/20/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineTEXASYes
2207R00000XInternal MedicineTEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1082891502MEDICAIDTEXAS
200NB71MEDICARE PINTEXAS
3084372401MEDICAIDTEXAS
400H232MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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