Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | J3320 | TX |
NPI | 1992705883 |
---|---|
Provider Name | Sharon H Richter |
First Address | Texarkana, TX 75503-9766 |
Second Address | Texarkana, TX 75503-9766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 14/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G86455 | (02) |