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General NPI Number Information
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NPI Number | 1548346323
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Entity Type | Organization
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Legal Business Name | RICHARD C. PENA, M.D., P.A.
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 1607 BROOK AVE
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5619
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Country | US
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Telephone | 940-767-5581
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Fax | 940-767-0046
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Provider Business Mailing Address
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Address Line | 1607 BROOK AVE
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5619
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Country | US
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Telephone | 940-767-5581
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Fax | 940-767-0046
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. RICHARD C PENA
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Credential | MD
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Telephone | 940-767-5581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | F1895
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License Number State | TX
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