Healthcare Provider Details

I. General information

NPI: 1922187913
Provider Name (Legal Business Name): RICHARD CARTER CAULEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 JOHNSON
BIG SPRING TX
79721-0629
US

IV. Provider business mailing address

PO BOX 629 701 JOHNSON
BIG SPRING TX
79721-0629
US

V. Phone/Fax

Practice location:
  • Phone: 432-267-4544
  • Fax: 432-267-4870
Mailing address:
  • Phone: 432-267-4544
  • Fax: 432-267-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11059
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: