MEDICARE: RICHARD DATU

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	235Z00000X	Speech-Language Pathologist	115529	TX

General Provider Information

NPI Number	:	1376474171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD DATU

Provider Business Mailing Address
First Line	:	2815 GAELIC GREEN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4647
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2815 GAELIC GREEN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-4647
Country	:	US
Telephone Number	:	409-225-0839
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ RICHARD DATU ” Practice Location

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