Provider Demographics
NPI:1477524049
Name:RICHARDS, DENNIS J (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:J
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E SAVANNAH AVE
Mailing Address - Street 2:BLDG C101
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1242
Mailing Address - Country:US
Mailing Address - Phone:956-686-2626
Mailing Address - Fax:956-686-1616
Practice Address - Street 1:110 E SAVANNAH AVE
Practice Address - Street 2:STE. 101 & 102 BLDG. C
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1242
Practice Address - Country:US
Practice Address - Phone:956-686-2626
Practice Address - Fax:956-686-1616
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678383163W00000X
TXAP111070367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85172UOtherBCBS
TX149985707Medicaid
TX149985707Medicaid