Provider Demographics
NPI:1649407537
Name:RICHEY, DEZAREI ESTELLE (GNP)
Entity Type:Individual
Prefix:
First Name:DEZAREI
Middle Name:ESTELLE
Last Name:RICHEY
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 ST. JOSEPH PKWY
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:281-727-3400
Mailing Address - Fax:713-727-3490
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:SUITE 246
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2420
Practice Address - Country:US
Practice Address - Phone:713-468-2358
Practice Address - Fax:713-468-2595
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX708676363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology