MEDICARE: RICHARD ANDREWS ANGEL DO

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	207Q00000X	Family Medicine Physician	N4911	TX

General Provider Information

NPI Number	:	1760570527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD ANDREWS ANGEL DO

Provider Business Mailing Address
First Line	:	2032 GLENCO TER
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-1704
Country	:	US
Telephone Number	:	910-528-2546
Fax Number	:

Provider Business Practice Location Address
First Line	:	2032 GLENCO TER
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-1704
Country	:	US
Telephone Number	:	910-528-2546
Fax Number	:

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	06/17/2025

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