Provider Demographics
NPI:1770691123
Name:MCPHERSON, RICHARD SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SCOTT
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1545 E SOUTHLAKE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6422
Mailing Address - Country:US
Mailing Address - Phone:817-442-9300
Mailing Address - Fax:817-796-0763
Practice Address - Street 1:3142 HORIZON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7809
Practice Address - Country:US
Practice Address - Phone:972-772-9600
Practice Address - Fax:972-772-9601
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY234619174400000X
TXM9502208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000528896002OtherBLUE CROSS/COMMUNITY BLUE
NY3012977OtherINDEPENDENT HEALTH
NYI48272Medicare UPIN
NYRA9264Medicare ID - Type Unspecified