Provider Demographics
NPI:1932115136
Name:HOZDIC, RICHARD LEROY II (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEROY
Last Name:HOZDIC
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:5002 COWHORN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-9766
Mailing Address - Country:US
Mailing Address - Phone:903-614-3000
Mailing Address - Fax:903-614-3525
Practice Address - Street 1:305 N WILLIAM ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551-2300
Practice Address - Country:US
Practice Address - Phone:903-614-3630
Practice Address - Fax:903-614-3525
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ8587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080108632OtherMEDICARE RR
TX116919503Medicaid
117838OtherCHIPS
AR97677OtherBCBS
A012OtherCHAMPUS
TX83610FOtherBCBS
AR97677OtherBCBS