Provider Demographics
NPI:1003802703
Name:SCRIVEN, RICHARD R (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:SCRIVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4300 CITY POINT DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-8380
Mailing Address - Country:US
Mailing Address - Phone:817-784-8268
Mailing Address - Fax:817-590-2285
Practice Address - Street 1:4300 CITY POINT DR
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8380
Practice Address - Country:US
Practice Address - Phone:817-784-8268
Practice Address - Fax:817-590-2285
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL0579208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100724703Medicaid
TX100724701Medicaid
TX100724702Medicaid
TX100724704Medicaid
TX100724705Medicaid
TX100724704Medicaid
TX100724702Medicaid
TX100724703Medicaid
TX8036J6Medicare PIN