MEDICARE: MICHAEL F RIGGINS LPC

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	101YP2500X	Professional Counselor	TSB05892	TX

General Provider Information

NPI Number	:	1861684706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL F RIGGINS LPC

Provider Business Mailing Address
First Line	:	4044 MCLEAN RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76117-1002
Country	:	US
Telephone Number	:	432-353-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	4044 MCLEAN RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76117-1002
Country	:	US
Telephone Number	:	432-353-4545
Fax Number	:

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

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	08/14/2007

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