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General NPI Number Information
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NPI Number | 1215121793
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Entity Type | Organization
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Legal Business Name | RICHARD A REDD MD PA
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 03/04/2010
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Provider Practice Location Address
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Address Line | 2319 BROOK HOLLOW DR
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2206
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Country | US
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Telephone | 806-355-6593
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Fax | 806-352-8774
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Provider Business Mailing Address
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Address Line | PO BOX 8337
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City | AMARILLO
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State | TX
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Zip | 79114-8337
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Country | US
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Telephone | 806-355-6593
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Fax | 806-352-8774
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. RICHARD ALLAN REDD
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Credential | MD
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Telephone | 940-691-9382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | F2870
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License Number State | TX
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