Provider Demographics
NPI:1720201916
Name:RICHARD L. SCOTT, O.D., P.A.
Entity Type:Organization
Organization Name:RICHARD L. SCOTT, O.D., P.A.
Other - Org Name:KLEIN EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INSURANCE SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:EJERCITO
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-370-2020
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1720201916OtherGROUP NPI
TX0171380001Medicare NSC
TX00606NMedicare PIN