Provider Demographics
NPI:1578735353
Name:TOWNSLEY, RICHARD WAYNE II
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:WAYNE
Last Name:TOWNSLEY
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 DENTON HWY
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:WATAUGA
Mailing Address - State:TX
Mailing Address - Zip Code:76148-2506
Mailing Address - Country:US
Mailing Address - Phone:817-428-4005
Mailing Address - Fax:817-428-4057
Practice Address - Street 1:6500 DENTON HWY
Practice Address - Street 2:SUITE B-1
Practice Address - City:WATAUGA
Practice Address - State:TX
Practice Address - Zip Code:76148-2506
Practice Address - Country:US
Practice Address - Phone:817-428-4005
Practice Address - Fax:817-428-4057
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist