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NPI Code Detail

MEDICARE: MR. RICHARD DEAN CALKINS FNP

MEDICARE: MR. RICHARD DEAN CALKINS FNP
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
1363LF0000XFamily Nurse Practitioner642379TX
2363L00000XNurse PractitionerAP121754TX

General Provider Information

NPI Number : 1790042406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD DEAN CALKINS FNP
Provider Business Mailing Address
First Line : 2401 WALKER PLACE BLVD
Second Line : # 300
City : COPPERAS COVE
State : TX
Zip : 76522-4025
Country : US
Telephone Number : 254-547-5516
Fax Number :
Provider Business Practice Location Address
First Line : 2401 WALKER PLACE BLVD
Second Line : # 300
City : COPPERAS COVE
State : TX
Zip : 76522-4025
Country : US
Telephone Number : 254-547-5516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2012
Last Update Date : 10/20/2020

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Directions to “ MR. RICHARD DEAN CALKINS FNP” Practice Location

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