MEDICARE: RICHARD A REDD MD PA

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	2085R0202X	Diagnostic Radiology Physician	F2870	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00282477	OTHER	TX	DPS REGISTRATION

General Provider Information

NPI Number	:	1215121793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD A REDD MD PA

Provider Business Mailing Address
First Line	:	PO BOX 8337
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79114-8337
Country	:	US
Telephone Number	:	806-355-6593
Fax Number	:	806-352-8774

Provider Business Practice Location Address
First Line	:	2319 BROOK HOLLOW DR
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76308-2206
Country	:	US
Telephone Number	:	806-355-6593
Fax Number	:	806-352-8774

Authorized Official
Title or Position	:	RADIOLOGIST
Name	:	DR. RICHARD ALLAN REDD
Credential	:	MD
Telephone Number	:	940-691-9382

Provider Enumeration Date	:	08/28/2007
Last Update Date	:	03/04/2010

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Directions to “RICHARD A REDD MD PA ” Practice Location

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