MEDICARE: MS. JUDITH H RICHARDSON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NX0800X	Orthopedic Chiropractor	TX4738	TX

General Provider Information

NPI Number	:	1124044391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH H RICHARDSON D.C.

Provider Business Mailing Address
First Line	:	PO BOX 280
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-0280
Country	:	US
Telephone Number	:	281-326-4980
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 NASA PKWY
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-6465
Country	:	US
Telephone Number	:	281-326-4980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/08/2007

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