MEDICARE: DR. RICHARD TREADWELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	J2381	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00843041	OTHER	TX	RAILROAD MEDICARE
6	P00779517	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8CB138	OTHER	TX	BLUE CROSS BLUE SHIED
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	8AW314	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1033110051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD TREADWELL M.D.

Provider Business Mailing Address
First Line	:	2411 FOUNTAIN VIEW DR STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-4817
Country	:	US
Telephone Number	:	713-620-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2411 FOUNTAIN VIEW DR STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-4817
Country	:	US
Telephone Number	:	713-620-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	09/28/2010

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Directions to “ DR. RICHARD TREADWELL M.D.” Practice Location

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