Provider Demographics
NPI:1285855445
Name:JONES, RICHARD MATTHEW (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:MATTHEW
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 S CAPITAL OF TEXAS HWY
Mailing Address - Street 2:STE A132
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-328-0156
Mailing Address - Fax:512-328-8420
Practice Address - Street 1:1301 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:STE A132
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-328-0156
Practice Address - Fax:512-328-8420
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX170291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
845109OtherUNITED CONCORDIA