Provider Demographics
NPI:1700236510
Name:CAIN, RICHARD TITUS (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:TITUS
Last Name:CAIN
Suffix:
Gender:M
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W PARK
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-8336
Mailing Address - Country:US
Mailing Address - Phone:936-328-5820
Mailing Address - Fax:
Practice Address - Street 1:210 W PARK
Practice Address - Street 2:SUITE 104
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8336
Practice Address - Country:US
Practice Address - Phone:936-328-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131136363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily