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NPI Code Detail

MEDICARE: RICHARD E DATA M.D.

MEDICARE: RICHARD E DATA 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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician34844NC

General Provider Information

NPI Number : 1316034044
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD E DATA M.D.
Provider Business Mailing Address
First Line : PO BOX 667
Second Line :
City : DESOTO
State : TX
Zip : 75123-0667
Country : US
Telephone Number : 469-567-6630
Fax Number : 469-567-6680
Provider Business Practice Location Address
First Line : 364 WHITE OAK ST
Second Line :
City : ASHEBORO
State : NC
Zip : 27203-5434
Country : US
Telephone Number : 336-328-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 06/07/2026

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