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1932320389

NPI Code Detail

MEDICARE: RICQUE L. BRISTER MD

MEDICARE: RICQUE L. BRISTER 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	2084P0800X	Psychiatry Physician	A-42685	CA
2	2084P0800X	Psychiatry Physician	G4857	TX
3	2084P0800X	Psychiatry Physician	ME145234	FL
4	208D00000X	General Practice Physician	ME145234	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932320389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICQUE L. BRISTER MD

Provider Business Mailing Address
First Line	:	4441 E KINGS CANYON RD
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93702-3604
Country	:	US
Telephone Number	:	559-600-4645
Fax Number	:

Provider Business Practice Location Address
First Line	:	7877 WILLOW CHASE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5934
Country	:	US
Telephone Number	:	832-869-4818
Fax Number	:	832-241-2902

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	02/04/2026

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Directions to “ RICQUE L. BRISTER MD” Practice Location

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