Provider Demographics
NPI:1962462002
Name:NIXON, RICHARD G (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:G
Last Name:NIXON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 NORTH LOOP W STE 115
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1392
Mailing Address - Country:US
Mailing Address - Phone:713-864-2663
Mailing Address - Fax:713-802-0684
Practice Address - Street 1:1919 NORTH LOOP W STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1392
Practice Address - Country:US
Practice Address - Phone:713-864-2663
Practice Address - Fax:713-802-0684
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8317207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00866VMedicare PIN
TX8B2556Medicare PIN
TXD67027Medicare UPIN