Delezene, Richard Lawrence
Delezene, Richard Lawrence is an individual health care provider with primary practice located at 4421 Highway 6 S Ste 100 , College Station TX 77845-6176. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Delezene, Richard Lawrence can be contacted via phone (979) 731-5200.Contact Information
Primary practice address
4421 Highway 6 S Ste 100
College Station TX 77845-6176
Phone: (979) 731-5200
Fax: (979) 731-5210
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA05116 | Texas |
Profile Details
| NPI number | 1982724134 |
|---|---|
| LBN Legal business name | Delezene, Richard Lawrence |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2007 |
| Last updated | Nov 22nd, 2023 - about 2 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 | 1982724134 | NPPES |
| Texas | MEDICAID | 198917005 |
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