Provider Demographics
NPI:1124551973
Name:UPSHAW, RICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:RICHELLE
Middle Name:
Last Name:UPSHAW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 W KATHERINE P RAINES RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7464
Mailing Address - Country:US
Mailing Address - Phone:817-556-7785
Mailing Address - Fax:817-556-7786
Practice Address - Street 1:2010 W KATHERINE P RAINES RD STE 500
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7464
Practice Address - Country:US
Practice Address - Phone:817-556-7785
Practice Address - Fax:817-556-7786
Is Sole Proprietor?:No
Enumeration Date:2017-04-09
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS6967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine