Provider Demographics
NPI:1609868371
Name:SCOTT, RICHARD LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:SCOTT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8220 LOUETTA RD
Mailing Address - Street 2:STE 112
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7029
Mailing Address - Country:US
Mailing Address - Phone:281-370-2020
Mailing Address - Fax:281-251-2705
Practice Address - Street 1:8220 LOUETTA RD
Practice Address - Street 2:STE 112
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7029
Practice Address - Country:US
Practice Address - Phone:281-370-2020
Practice Address - Fax:281-251-2705
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2756TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1720201916OtherGROUP NPI
TX1609868371OtherNPI
TX81250EMedicare UPIN
TX0171380001Medicare NSC
TX00606NMedicare PIN