Individual
DR. JARED LEE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4401 BOOTH CALLOWAY RD, NORTH RICHLAND HILLS, TX 76180-7371
(972) 540-4919
Mailing address
PO BOX 201606, DALLAS, TX 75320-1606
(972) 519-1940
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L7139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8F6637
BCBS
TX
01
—
P00054126
MEDICARE RAILROAD
TX
Enumeration date
01/12/2006
Last updated
12/05/2007
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