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General NPI Number Information
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NPI Number | 1861969701
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Entity Type | Individual
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Provider Name | BRIAN J RICHEY ATP
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Gender | Male
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Dates
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Enumeration Date | 10/29/2018
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 210 ENTERPRISE ST STE C
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City | LONGVIEW
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State | TX
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Zip | 75604-5071
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Country | US
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Telephone | 972-480-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 N GLENVILLE DR STE 501
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City | RICHARDSON
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State | TX
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Zip | 75081-1957
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Country | US
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Telephone | 972-480-0990
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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 | 225CA2500X
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Taxonomy Name | Assistive Technology Supplier Rehabilitation Counselor
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License Number | 89467
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | 89467
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225CA2400X
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Taxonomy Name | Assistive Technology Practitioner Rehabilitation Counselor
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License Number | 89467
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License Number State | TX
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