Individual
JESSICA PAIGE RICHMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
700 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845
(979) 207-0100
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04660
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180787701
—
TX
01
—
8N9647
BLUE CROSS BLUE SHIELD
TX
01
—
P00281541
RAILROAD MEDICARE
TX
Enumeration date
10/04/2006
Last updated
12/28/2021
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