Healthcare Provider Details

I. General information

NPI: 1306273420
Provider Name (Legal Business Name): RICHA GARG O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 CORTEZ RD W
BRADENTON FL
34207-1241
US

IV. Provider business mailing address

5650 WORTH PKWY APT 5416
SAN ANTONIO TX
78257-1536
US

V. Phone/Fax

Practice location:
  • Phone: 941-756-2020
  • Fax: 941-756-4486
Mailing address:
  • Phone: 845-797-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number046011122
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6726
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number9590TG
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number008079
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: