Provider Demographics
NPI:1720078660
Name:DEVILLEZ, RICHARD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:DEVILLEZ
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 1:4141 S STAPLES ST # 300
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2155
Mailing Address - Country:US
Mailing Address - Phone:316-882-5560
Mailing Address - Fax:316-882-6011
Practice Address - Street 1:4141 S STAPLES ST # 300
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2155
Practice Address - Country:US
Practice Address - Phone:316-882-5560
Practice Address - Fax:316-882-6011
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-23
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE 0324207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology