Individual
JAQUELINE THERESA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, AGPCNP-BC
Contact information
Practice address
1331 W GRAND PKWY N STE 230, KATY, TX 77493-2711
(281) 392-8620
Mailing address
24431 GOODWIN DR, KATY, TX 77493-3523
(618) 444-5443
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
1110933
TX
363LG0600X
Gerontology Nurse Practitioner
1110933
TX
363LP2300X
Primary Care Nurse Practitioner
1110933
TX
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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