MEDICARE: MRS. LINDSEY E. RICHARDS MD

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	207N00000X	Dermatology Physician	S3056	TX

General Provider Information

NPI Number	:	1710373105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSEY E. RICHARDS MD

Provider Business Mailing Address
First Line	:	401 RANCH ROAD 620 S STE 200
Second Line	:
City	:	LAKEWAY
State	:	TX
Zip	:	78734-5304
Country	:	US
Telephone Number	:	512-610-0549
Fax Number	:	512-666-3744

Provider Business Practice Location Address
First Line	:	401 RANCH ROAD 620 S STE 200
Second Line	:
City	:	LAKEWAY
State	:	TX
Zip	:	78734-5304
Country	:	US
Telephone Number	:	512-610-0549
Fax Number	:	512-666-3744

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

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	08/12/2019

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