Provider Demographics
NPI:1225058852
Name:NOEL, RICHARD L (M D)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:NOEL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17115 RED OAK DR
Mailing Address - Street 2:SUITE 119
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2641
Mailing Address - Country:US
Mailing Address - Phone:281-440-6899
Mailing Address - Fax:281-587-1164
Practice Address - Street 1:17115 RED OAK DR
Practice Address - Street 2:SUITE 119
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2607
Practice Address - Country:US
Practice Address - Phone:281-440-6899
Practice Address - Fax:281-587-1164
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH70862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOJ88SOtherBLUE CROSS/BLUE SHIELD
TX1003412OtherCIGNA
TX4344947OtherAETNA
TX10019556OtherAMERIGROUP
TX115162301Medicaid
TX115162301Medicaid
TXOOJ88SMedicare ID - Type Unspecified