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General NPI Number Information
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NPI Number | 1932293602
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Entity Type | Organization
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Legal Business Name | RICHARD L. VERA MD, PA
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 1615 LANCASTER DR STE #150
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City | GRAPEVINE
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State | TX
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Zip | 76051-2111
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Country | US
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Telephone | 817-421-0279
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Fax | 817-416-7490
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Provider Business Mailing Address
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Address Line | 804 SCOTT NIXON MEMORIAL DR
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City | AUGUSTA
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State | GA
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Zip | 30907
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Country | US
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Telephone | 800-394-4445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD L VERA
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Credential | MD
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Telephone | 817-421-0279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | J1583
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License Number State | TX
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