Provider Demographics
NPI:1629054291
Name:BYRD, RICHARD A (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:RICHARD BYRD MD
Mailing Address - Street 2:PO BOX 93358
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193
Mailing Address - Country:US
Mailing Address - Phone:702-487-6510
Mailing Address - Fax:702-946-1354
Practice Address - Street 1:6402 MCLEOD DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120
Practice Address - Country:US
Practice Address - Phone:702-487-6510
Practice Address - Fax:702-946-1354
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9933207L00000X, 207LC0200X
AZ45275207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBI452TMedicare PIN
NVV104370Medicare PIN
NVV35664Medicare PIN