Provider Demographics
NPI:1437181237
Name:EASTON, RICHARD LEE (PA-L, MS, BS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:EASTON
Suffix:
Gender:M
Credentials:PA-L, MS, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 W MAIN ST # 120
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3513
Mailing Address - Country:US
Mailing Address - Phone:972-436-7531
Mailing Address - Fax:972-436-6114
Practice Address - Street 1:751 W MAIN ST # 120
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3513
Practice Address - Country:US
Practice Address - Phone:972-436-7531
Practice Address - Fax:972-436-6114
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2020-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07600363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical