Provider Demographics
NPI:1942938865
Name:MOLL, RICHARD CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHRISTOPHER
Last Name:MOLL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3919
Mailing Address - Country:US
Mailing Address - Phone:713-345-0115
Mailing Address - Fax:
Practice Address - Street 1:439 W 17TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3919
Practice Address - Country:US
Practice Address - Phone:713-345-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19313235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist