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General NPI Number Information
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NPI Number | 1386342772
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Entity Type | Individual
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Provider Name | JAQUELINE THERESA RICHARD APRN, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/16/2023
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 1331 W GRAND PKWY N STE 230
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City | KATY
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State | TX
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Zip | 77493-2711
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Country | US
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Telephone | 281-392-8620
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Fax |
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Provider Business Mailing Address
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Address Line | 24431 GOODWIN DR
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City | KATY
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State | TX
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Zip | 77493-3523
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Country | US
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Telephone | 618-444-5443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1110933
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1110933
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1110933
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License Number State | TX
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