Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 15869 | TX |
Y | 213EG0000X | General Practice | 15869 | TX |
NPI | 1003877697 |
---|---|
Provider Name | Dr. Greg Richards |
First Address | Houston, TX 77056-3226 |
Second Address | Houston, TX 77056-3226 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 27/08/2012 |