Provider Demographics
NPI:1306864533
Name:BELCHER, RICHIE ALLEN (FNP)
Entity Type:Individual
Prefix:
First Name:RICHIE
Middle Name:ALLEN
Last Name:BELCHER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 W MOCKINGBIRD LN STE 550
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4902
Mailing Address - Country:US
Mailing Address - Phone:469-904-3555
Mailing Address - Fax:214-819-2405
Practice Address - Street 1:4621 S COOPER ST
Practice Address - Street 2:SUITE-131
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5866
Practice Address - Country:US
Practice Address - Phone:888-330-6861
Practice Address - Fax:817-293-8091
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP108827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1118598-03Medicaid
TX1118598-02Medicaid
2432891OtherUNITED HEALTH CARE
TX82N227OtherBLUE CROSS BLUE SHIELD
TX1118598-01Medicaid
S67748Medicare UPIN
TX1118598-03Medicaid
TX82N227OtherBLUE CROSS BLUE SHIELD
86N518Medicare ID - Type Unspecified