Provider Demographics
NPI:1265894604
Name:JOHN W. RICHARD, MD, PLLC
Entity type:Organization
Organization Name:JOHN W. RICHARD, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:214-952-3445
Mailing Address - Street 1:4604 SEBAGO TRAIL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093
Mailing Address - Country:US
Mailing Address - Phone:214-952-3445
Mailing Address - Fax:
Practice Address - Street 1:4604 SEBAGO TRL
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3394
Practice Address - Country:US
Practice Address - Phone:214-952-3445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7580207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty