Individual
RICHARD NEAL GREEN SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 HOSPITAL DR, SUITE 210, CORSICANA, TX 75110-2489
(903) 641-4835
(903) 641-4846
Mailing address
400 HOSPITAL DR STE 111, CORSICANA, TX 75110-2489
(903) 641-4895
(903) 641-4894
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
D8242
TX
207VX0000X
Obstetrics Physician
Primary
D8242
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100626403
—
TX
05
—
100626404
—
TX
01
—
8CA699
BLUE CROSS
TX
Enumeration date
02/14/2006
Last updated
11/28/2011
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