Healthcare Provider Details

I. General information

NPI: 1851136907
Provider Name (Legal Business Name): JOSEPH ANTHONY RICHARDSON JR. MSN, APRN, AGACNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2024
Last Update Date: 06/29/2024
Certification Date: 06/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 UNIVERSITY BLVD STE 6.146
GALVESTON TX
77555-5302
US

IV. Provider business mailing address

2801 FM 2004 RD APT 414
TEXAS CITY TX
77591-9150
US

V. Phone/Fax

Practice location:
  • Phone: 409-772-1285
  • Fax: 409-772-5611
Mailing address:
  • Phone: 409-256-4457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1157555
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: