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NPI Code Detail

MEDICARE: TY'COIA RICHARD

MEDICARE:   TY'COIA  RICHARD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1275251498
Entity Type Code : Individual
Provider Name (Legal Business Name) : TY'COIA RICHARD
Provider Business Mailing Address
First Line : 3100 CLEBURNE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-4501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3100 CLEBURNE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77004-4598
Country : US
Telephone Number : 713-313-7444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2022
Last Update Date : 08/15/2022

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Directions to “ TY'COIA RICHARD ” Practice Location

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