Organization
NICOLAS RICH JR MD FAAP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLAS RICH JR. MD (MD)
(915) 544-4484
Entity
Organization
Contact information
Practice address
2905 N STANTON ST, EL PASO, TX 79902-2510
(915) 544-4484
(915) 544-4590
Mailing address
2905 N STANTON ST, EL PASO, TX 79902-2510
(915) 544-4484
(915) 544-4590
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157088901
MEDICAID GROUP
TX
Enumeration date
11/22/2006
Last updated
09/21/2012
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