Provider Demographics
NPI:1851623409
Name:H. MILLER RICHERT, M.D., P.A.
Entity Type:Organization
Organization Name:H. MILLER RICHERT, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:H
Authorized Official - Middle Name:MILLER
Authorized Official - Last Name:RICHERT
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:325-670-3937
Mailing Address - Street 1:1750 PINE STREET
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3044
Mailing Address - Country:US
Mailing Address - Phone:325-670-3937
Mailing Address - Fax:325-673-6291
Practice Address - Street 1:1750 PINE STREET
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3044
Practice Address - Country:US
Practice Address - Phone:325-670-3937
Practice Address - Fax:325-673-6291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0644207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126137201Medicaid
TXC21075Medicare UPIN
00EJ81Medicare PIN