Provider Demographics
NPI:1447581426
Name:KNOWLES, RICKY NORMAN
Entity Type:Individual
Prefix:MR
First Name:RICKY
Middle Name:NORMAN
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 MELODY PEAK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-2553
Mailing Address - Country:US
Mailing Address - Phone:713-484-9647
Mailing Address - Fax:281-485-4262
Practice Address - Street 1:4615 SOUTHWEST FWY
Practice Address - Street 2:#420
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7108
Practice Address - Country:US
Practice Address - Phone:713-484-9647
Practice Address - Fax:281-485-4262
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130614174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist