Individual
RICHARD O HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1824 WESTOVER SQ, FORT WORTH, TX 76107-3501
(817) 996-1903
Mailing address
1824 WESTOVER SQ, FORT WORTH, TX 76107-3501
(817) 996-1903
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
F4870
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120112106
—
TX
01
—
8H9673
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/26/2006
Last updated
09/22/2014
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