Provider Demographics
NPI:1558367664
Name:JONES, RICHARD EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:EDWARD
Last Name:JONES
Suffix:
Gender:M
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:PO BOX 660046
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0046
Mailing Address - Country:US
Mailing Address - Phone:214-369-8555
Mailing Address - Fax:214-369-2683
Practice Address - Street 1:5920 FOREST PARK RD
Practice Address - Street 2:STE 600
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6416
Practice Address - Country:US
Practice Address - Phone:214-902-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4790207XS0106X, 207X00000X, 207XS0114X, 207XX0005X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89035FOtherBCBS
TX123892504Medicaid
D66688Medicare UPIN
TX89035FMedicare PIN
TX89035FOtherBCBS