Provider Demographics
NPI:1891877759
Name:RICHARDSON, ROBBYN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBBYN
Middle Name:D
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 EMANCIPATION AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-4227
Mailing Address - Country:US
Mailing Address - Phone:713-807-8800
Mailing Address - Fax:713-807-8818
Practice Address - Street 1:3619 EMANCIPATION AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-4227
Practice Address - Country:US
Practice Address - Phone:713-807-8800
Practice Address - Fax:713-807-8818
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215941223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1757106Medicaid
TX1757106Medicaid