Provider Demographics
NPI:1881623114
Name:FLEMING, RICHARD YOUATT-DECLAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:YOUATT-DECLAN
Last Name:FLEMING
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:901 W 38TH ST
Practice Address - Street 2:200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1163
Practice Address - Country:US
Practice Address - Phone:512-421-4100
Practice Address - Fax:512-454-4575
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7055208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01768177OtherRAILROAD
TX1296519-06Medicaid
TX129651908Medicaid
TX437847YK4EMedicare PIN
TXP01768177OtherRAILROAD
TXF80948Medicare UPIN
TX437847YKYCMedicare PIN