Provider Demographics
NPI:1811998420
Name:PALMER, RICHARD EARLE JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:EARLE
Last Name:PALMER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:12345 JONES RD
Mailing Address - Street 2:STE. 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4855
Mailing Address - Country:US
Mailing Address - Phone:281-469-2181
Mailing Address - Fax:281-894-8611
Practice Address - Street 1:12345 JONES RD
Practice Address - Street 2:STE. 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4855
Practice Address - Country:US
Practice Address - Phone:281-469-2181
Practice Address - Fax:281-894-8611
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-04
Last Update Date:2007-12-17
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Provider Licenses
StateLicense IDTaxonomies
TXF43502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00TX79Medicare PIN