Black, Richard C
Black, Richard C is an sole proprietor health care provider with primary practice located at 1514 Zaragosa Rd Ste. A-2, El Paso TX 79936-7905. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Black, Richard C can be contacted via phone (915) 592-5853.Contact Information
Primary practice address
1514 Zaragosa Rd Ste. A-2
El Paso TX 79936-7905
Phone: (915) 592-5853
Fax: (915) 591-0381
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 11053 | Texas |
Profile Details
| NPI number | 1184896078 |
|---|---|
| LBN Legal business name | Black, Richard C |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2008 |
| Last updated | Mar 26th, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184896078 | NPPES |
| Texas | MEDICAID | 009005202 | |
| Texas | MEDICAID | 9177596 | |
| Texas | MEDICAID | 169606401 |
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