Provider Demographics
NPI:1144277542
Name:RICHARDSON PHYSICIAN ALLIANCE
Entity type:Organization
Organization Name:RICHARDSON PHYSICIAN ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-498-4700
Mailing Address - Street 1:401 W CAMPBELL RD
Mailing Address - Street 2:ATTN: SHIRLEY BUTLER
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3416
Mailing Address - Country:US
Mailing Address - Phone:972-498-4700
Mailing Address - Fax:972-498-4883
Practice Address - Street 1:401 W CAMPBELL RD
Practice Address - Street 2:ATTN: SHIRLEY BUTLER
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3416
Practice Address - Country:US
Practice Address - Phone:972-498-4700
Practice Address - Fax:972-498-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155154101Medicaid
TXCK7047OtherRR MEDICARE
TX00563UMedicare PIN