Provider Demographics
NPI:1548232531
Name:FLEMING, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3238
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0055
Mailing Address - Country:US
Mailing Address - Phone:956-618-3979
Mailing Address - Fax:956-618-3975
Practice Address - Street 1:833 W DOVE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3508
Practice Address - Country:US
Practice Address - Phone:956-618-3979
Practice Address - Fax:956-618-3975
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6583207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127485406Medicaid
TX127485407Medicaid
8U5311OtherBLUE CROSS BLUE SHIELD
TXP00266640OtherRAILROAD MEDICARE
TXF10512Medicare UPIN
TX127485406Medicaid