Provider Demographics
NPI:1891739777
Name:RICHARD, VALERIE CAMILLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:CAMILLE
Last Name:RICHARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18103 GLEN CYPRESS CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7610
Mailing Address - Country:US
Mailing Address - Phone:281-859-4484
Mailing Address - Fax:
Practice Address - Street 1:31303 FM 2920 RD
Practice Address - Street 2:SUITE G
Practice Address - City:WALLER
Practice Address - State:TX
Practice Address - Zip Code:77484-8197
Practice Address - Country:US
Practice Address - Phone:936-931-3448
Practice Address - Fax:936-931-3704
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX643349363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1776411Medicaid