MEDICARE: DR. ANAISSA ARIANA RICHARDSON PHARMD

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	183500000X	Pharmacist	8871985	ID

General Provider Information

NPI Number	:	1790647386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANAISSA ARIANA RICHARDSON PHARMD

Provider Business Mailing Address
First Line	:	1904 DARTMOUTH ST APT B1
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-3980
Country	:	US
Telephone Number	:	956-282-9655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1904 DARTMOUTH ST APT B1
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-3980
Country	:	US
Telephone Number	:	956-282-9655
Fax Number	:

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

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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