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NPI Code Detail

MEDICARE: MRS. ANGELA RICHARDSON

MEDICARE: MRS. ANGELA 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
1183700000XPharmacy Technician102008TX

General Provider Information

NPI Number : 1558915660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA RICHARDSON
Provider Business Mailing Address
First Line : 5605 COLLEYVILLE BLVD
Second Line :
City : COLLEYVILLE
State : TX
Zip : 76034-6022
Country : US
Telephone Number : 817-577-5030
Fax Number : 817-503-7862
Provider Business Practice Location Address
First Line : 5605 COLLEYVILLE BLVD
Second Line :
City : COLLEYVILLE
State : TX
Zip : 76034-6022
Country : US
Telephone Number : 817-577-5030
Fax Number : 817-503-7862
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2019
Last Update Date : 07/26/2019

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Directions to “ MRS. ANGELA RICHARDSON ” Practice Location

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