Provider Demographics
NPI:1558483032
Name:LACOUR, RICHARD EDWARD III (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EDWARD
Last Name:LACOUR
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2501 PALMER HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-7069
Mailing Address - Country:US
Mailing Address - Phone:409-945-0644
Mailing Address - Fax:409-945-8245
Practice Address - Street 1:2501 PALMER HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-7069
Practice Address - Country:US
Practice Address - Phone:409-945-0644
Practice Address - Fax:409-945-8245
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX191041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX334865OtherUNITED CONCORDIA GROUP
TX84D986OtherBLUE CROSS BLUE SHIELD
TX893520OtherUNITED CONCORDIA IND.