Provider Demographics
NPI:1033908595
Name:RICHARDSON, MORGAN BRADI (PT, DPT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:BRADI
Last Name:RICHARDSON
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-4173
Mailing Address - Country:US
Mailing Address - Phone:575-703-9800
Mailing Address - Fax:
Practice Address - Street 1:4229 78TH ST STE B
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1934
Practice Address - Country:US
Practice Address - Phone:806-902-8779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1367996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist