MEDICARE: RICHARD HA MD 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
1	2086S0122X	Plastic and Reconstructive Surgery Physician	K9795	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0031MB	OTHER	TX	BLUE CROSS BLUE SHIELD
2	K9795	OTHER	TX	MEDICAL LICENSE
3	H82896	OTHER	TX	UPIN

General Provider Information

NPI Number	:	1902941065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD HA MD PA

Provider Business Mailing Address
First Line	:	11970 N CENTRAL EXPY STE 270
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3770
Country	:	US
Telephone Number	:	214-818-0935
Fax Number	:	214-887-3525

Provider Business Practice Location Address
First Line	:	11970 N CENTRAL EXPY STE 270
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3770
Country	:	US
Telephone Number	:	214-818-0935
Fax Number	:	214-887-3525

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD HA
Credential	:	MD
Telephone Number	:	214-818-0935

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	05/10/2024

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Directions to “RICHARD HA MD PA ” Practice Location

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