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NPI Code Detail

MEDICARE: RICHMOND AVENUE FAMILY PRACTICE ASSOCIATES PA

MEDICARE: RICHMOND AVENUE FAMILY PRACTICE ASSOCIATES PA
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10065JVOTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1811982275
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHMOND AVENUE FAMILY PRACTICE ASSOCIATES PA
Provider Business Mailing Address
First Line : 12245 RICHMOND AVENUE
Second Line :
City : HOUSTON
State : TX
Zip : 77082-2518
Country : US
Telephone Number : 281-558-6700
Fax Number : 281-558-1741
Provider Business Practice Location Address
First Line : 12245 RICHMOND AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77082-2518
Country : US
Telephone Number : 281-558-6700
Fax Number : 281-558-1741
Authorized Official
Title or Position : PRESIDENT
Name : BRUCE C PATTERSON
Credential : MD
Telephone Number : 281-558-6700
Provider Enumeration Date : 09/13/2005
Last Update Date : 01/14/2010

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Directions to “RICHMOND AVENUE FAMILY PRACTICE ASSOCIATES PA ” Practice Location

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