Healthcare Provider Details

I. General information

NPI: 1508739293
Provider Name (Legal Business Name): DLRC ANCILLARY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 N JOSEY LN STE 100B
CARROLLTON TX
75010-4620
US

IV. Provider business mailing address

4333 N JOSEY LN STE 100B
CARROLLTON TX
75010-4620
US

V. Phone/Fax

Practice location:
  • Phone: 469-443-0925
  • Fax: 469-443-0925
Mailing address:
  • Phone: 469-443-0925
  • Fax: 469-443-0925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD G BUCH
Title or Position: OWNER/MD
Credential: MD
Phone: 469-443-0925