MEDICARE: RICHMARK FINANCIAL SERVICES GROUP INC

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	133VN1006X	Metabolic Nutrition Registered Dietitian	DT03675	TX

General Provider Information

NPI Number	:	1730176165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHMARK FINANCIAL SERVICES GROUP INC

Provider Business Mailing Address
First Line	:	9301 SOUTHWEST FREEWAY
Second Line	:	SUITE 250
City	:	HOUSTON
State	:	TX
Zip	:	77074-1518
Country	:	US
Telephone Number	:	713-270-9301
Fax Number	:	713-771-8303

Provider Business Practice Location Address
First Line	:	9301 SOUTHWEST FREEWAY
Second Line	:	SUITE 250
City	:	HOUSTON
State	:	TX
Zip	:	77074-1518
Country	:	US
Telephone Number	:	713-270-9301
Fax Number	:	713-771-8303

Authorized Official
Title or Position	:	SOLO PRACTIONER
Name	:	MARGARET B GUMTO
Credential	:	RD LD CDE
Telephone Number	:	713-270-9301

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	01/16/2008

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