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General NPI Number Information
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NPI Number | 1487855870
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Entity Type | Individual
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Provider Name | GERI RICHARDSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 08/11/2024
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Provider Practice Location Address
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Address Line | 4405 PADRE BLVD
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City | SOUTH PADRE ISLAND
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State | TX
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Zip | 78597-7324
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Country | US
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Telephone | 972-689-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 6223 WOODLAND DR
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City | DALLAS
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State | TX
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Zip | 75225-2838
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Country | US
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Telephone | 972-689-1800
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 65303
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | H8352
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License Number State | TX
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