Provider Demographics
NPI:1245253822
Name:RICHEY, WILLIAM GLENN (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GLENN
Last Name:RICHEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 HIGHWAY 6
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4370
Mailing Address - Country:US
Mailing Address - Phone:281-208-5999
Mailing Address - Fax:
Practice Address - Street 1:6701 HIGHWAY 6
Practice Address - Street 2:SUITE 140
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4370
Practice Address - Country:US
Practice Address - Phone:281-208-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4936TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2603Medicare ID - Type Unspecified
TXU62179Medicare UPIN