Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | J2280 | TX |
NPI | 1710973995 |
---|---|
Provider Name | Hunter Richmond |
First Address | Denison, TX 75020-2079 |
Second Address | Sherman, TX 75092-6374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 29/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
035052201 | (05) | TX |
3380289 | BLUELINK (01) | TX |
4492270 | AETNA (01) | TX |
6826666002 | CIGNA (01) | TX |
752546971002 | TRICARE (01) | TX |
F80289 | (02) | TX |
J2280 | STATE LICENSE (01) | TX |
N60H | BCBS (01) | TX |