MEDICARE: DR. RICHARD MICHAEL BLISS M.D. PH.D.

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	208000000X	Pediatrics Physician	R9718	TX
2	207R00000X	Internal Medicine Physician	R9718	TX

General Provider Information

NPI Number	:	1154616787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD MICHAEL BLISS M.D. PH.D.

Provider Business Mailing Address
First Line	:	3021 GATEWAY DR STE 295
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2639
Country	:	US
Telephone Number	:	888-854-1397
Fax Number	:

Provider Business Practice Location Address
First Line	:	3021 GATEWAY DR STE 295
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2639
Country	:	US
Telephone Number	:	888-854-1397
Fax Number	:

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

Provider Enumeration Date	:	06/11/2011
Last Update Date	:	01/27/2026

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