Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD010634 | LA |
NPI | 1063410074 |
---|---|
Provider Name | Dr. Richard Paul Texada SR. |
First Address | Alexandria, LA 71301-3900 |
Second Address | Alexandria, LA 71301-3900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1792101 | (05) | LA |
B65692 | (02) |