Individual
MRS. BRANDI NICOLE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3617 O HARE DR, MESQUITE, TX 75150-4539
(972) 284-8600
Mailing address
535 GLEN COVE ST, SEAGOVILLE, TX 75159-2243
(214) 459-7487
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2128269
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2128269
APTA
TX
Enumeration date
08/24/2018
Last updated
08/24/2018
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