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NPI Code Detail

MEDICARE: MRS. TEAIRRA L RICHARDSON

MEDICARE:  MRS. TEAIRRA L RICHARDSON
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104437680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TEAIRRA L RICHARDSON
Provider Business Mailing Address
First Line : 20722 BRADFORD FOREST DR
Second Line :
City : CYPRESS
State : TX
Zip : 77433-3678
Country : US
Telephone Number : 816-447-1694
Fax Number :
Provider Business Practice Location Address
First Line : 4141 SOUTHWEST FWY STE 515
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7364
Country : US
Telephone Number : 816-447-1694
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2020
Last Update Date : 08/10/2020

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Directions to “ MRS. TEAIRRA L RICHARDSON ” Practice Location

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