Physician Compare National (NPI:1740480177)

HEALTHCARE PROVIDER: STEVEN JAY RICHARDSON MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1740480177
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961673587
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110912000378
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RICHARDSON
	Individual professional last name
Provider First Name	STEVEN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RICHARDSON DERMATOLOGY, PLLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8729396148
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7000 BRYANT IRVIN RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	FORT WORTH
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	761324251
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8178826338
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y