MEDICARE: ALLISON B RICHARD

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	363AM0700X	Medical Physician Assistant
2	363AM0700X	Medical Physician Assistant	25MP00933800	NJ
3	363A00000X	Physician Assistant	25MP00933800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA13178	OTHER	TX	PHYSICIAN ASSISTANT

General Provider Information

NPI Number	:	1346884228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON B RICHARD

Provider Business Mailing Address
First Line	:	3333 WESLAYAN ST APT 1350
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6381
Country	:	US
Telephone Number	:	703-887-9861
Fax Number	:

Provider Business Practice Location Address
First Line	:	4102 WOODLAWN AVE STE 160
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1922
Country	:	US
Telephone Number	:	832-879-2942
Fax Number	:	832-962-4937

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

Provider Enumeration Date	:	11/04/2019
Last Update Date	:	01/13/2026

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Directions to “ ALLISON B RICHARD ” Practice Location

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