Provider Demographics
NPI:1649583550
Name:ALVIN J. RICHARD, PC
Entity Type:Organization
Organization Name:ALVIN J. RICHARD, PC
Other - Org Name:CHIROPRACTIC FIRST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:936-334-0004
Mailing Address - Street 1:P.O. BOX 4096
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:TX
Mailing Address - Zip Code:77575-2296
Mailing Address - Country:US
Mailing Address - Phone:936-334-0004
Mailing Address - Fax:936-334-0010
Practice Address - Street 1:2720 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:TX
Practice Address - Zip Code:77575-3909
Practice Address - Country:US
Practice Address - Phone:936-334-0004
Practice Address - Fax:936-334-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0059WYOtherBC/BS TYPE 2 (GROUP)
TX8CZ242OtherBC/BS