Provider Demographics
NPI:1447242904
Name:DANIELSON, RICHARD W (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:DANIELSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5895
Mailing Address - Country:US
Mailing Address - Phone:281-996-0505
Mailing Address - Fax:281-483-3392
Practice Address - Street 1:NASA-JOHNSON SPACE CENTER SD32 AUDIOLOGY
Practice Address - Street 2:2101 NASA PARKWAY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3696
Practice Address - Country:US
Practice Address - Phone:281-244-6206
Practice Address - Fax:281-483-3392
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51566231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist