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NPI 1366054298

NPI 1366054298 : RONALD RICHARDSON OD PA PC : MCALLEN, TX

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General NPI Number Information
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    NPI Number           |    1366054298
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    Entity Type          |    Organization 
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    Legal Business Name  |    RONALD RICHARDSON OD PA PC 
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Dates
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    Enumeration Date     |    08/21/2020
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    Last Update Date     |    08/21/2020
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Provider Practice Location Address
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    Address Line         |    4100 N 10TH ST STE C 
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    City                 |    MCALLEN
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    State                |    TX
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    Zip                  |    78504-3003
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    Country              |    US
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    Telephone            |    956-992-0983
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    Fax                  |    956-992-1956
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Provider Business Mailing Address
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    Address Line         |    4100 N 10TH ST STE C 
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    City                 |    MCALLEN
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    State                |    TX
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    Zip                  |    78504-3003
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    Country              |    US
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    Telephone            |    956-992-0983
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    Fax                  |    956-992-1956
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Authorized Official
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    Title or Position    |    OD/OWNER
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    Name                 |    DR. RONALD W RICHARDSON 
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    Credential           |    OD
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    Telephone            |    956-992-0983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    
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    License Number State |    
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