Provider Demographics
NPI:1508173857
Name:RICHARD P HARPER, DDS, PHD, PA
Entity Type:Organization
Organization Name:RICHARD P HARPER, DDS, PHD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PHD, PA
Authorized Official - Phone:903-872-6685
Mailing Address - Street 1:729 W 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-2942
Mailing Address - Country:US
Mailing Address - Phone:903-872-6685
Mailing Address - Fax:903-872-6218
Practice Address - Street 1:729 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2942
Practice Address - Country:US
Practice Address - Phone:903-872-6685
Practice Address - Fax:903-872-6218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX200801223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141752903Medicaid
TXU54623Medicare UPIN