# SELF RICHARD DBA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003062472
- **Authorized official:** MR. RICHARD RAY BAKER SR. (HOME HEALTH NURSE AIDE)
- **Authorized official phone:** (817) 304-8292

## Contact information

- **Practice address:** 6701 CALMONT AVE APT 101, FORT WORTH, TX 76116-4239
- **Practice address phone:** (817) 304-2892
- **Practice address fax:** (817) 246-4764
- **Mailing address:** 6701 CALMONT AVE APT 101, FORT WORTH, TX 76116-4239
- **Mailing address phone:** (817) 304-2892
- **Mailing address fax:** (817) 246-4764

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | 09332825 | TX | — |
| 347C00000X | Private Vehicle | 09332825 | TX | Yes |

## Other

- **Enumeration date:** 08/17/2008
- **Last updated:** 08/17/2008