Organization
UTMB AT GALVESTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK RICHARDS PA (PHYSICIAN ASSISTANT)
(936) 258-8013
Entity
Organization
Contact information
Practice address
902 FM 686, DAYTON, TX 77535-2299
(936) 258-8013
Mailing address
902 FM 686, DAYTON, TX 77535-2299
(936) 258-8013
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PA00300
TX
Other
Enumeration date
03/06/2014
Last updated
03/06/2014
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