MEDICARE: MS. VONDA K RICHARDSON

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1316181993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VONDA K RICHARDSON

Provider Business Mailing Address
First Line	:	8326 QUAIL VIEW DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-5355
Country	:	US
Telephone Number	:	281-437-2284
Fax Number	:

Provider Business Practice Location Address
First Line	:	8326 QUAIL VIEW DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-5355
Country	:	US
Telephone Number	:	281-437-2284
Fax Number	:

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

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	04/27/2009

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