Provider Demographics
NPI:1750475489
Name:ISON, RICHARD LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:ISON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:120 E FM 544
Mailing Address - Street 2:STE 64
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4034
Mailing Address - Country:US
Mailing Address - Phone:972-424-4200
Mailing Address - Fax:972-424-1464
Practice Address - Street 1:120 E FM 544
Practice Address - Street 2:STE. 64
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4034
Practice Address - Country:US
Practice Address - Phone:972-424-4200
Practice Address - Fax:972-424-1464
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4274T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist