Provider Demographics
NPI:1497051023
Name:RICHMOND, HEATHER MAYS (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:MAYS
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17756 KATY FWY
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1334
Mailing Address - Country:US
Mailing Address - Phone:832-772-3330
Mailing Address - Fax:832-772-3332
Practice Address - Street 1:17756 KATY FWY
Practice Address - Street 2:SUITE G-1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1334
Practice Address - Country:US
Practice Address - Phone:832-772-3330
Practice Address - Fax:832-772-3332
Is Sole Proprietor?:No
Enumeration Date:2011-01-29
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5972207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CW313OtherBCBS INDIVIDUAL #
TXTXB136581Medicare PIN