Provider Demographics
NPI:1144642679
Name:GOLIGHTLY, RICHARD CLAYTON (PA-C)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CLAYTON
Last Name:GOLIGHTLY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 FM 517 RD W
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-3904
Mailing Address - Country:US
Mailing Address - Phone:713-482-4535
Mailing Address - Fax:713-482-4560
Practice Address - Street 1:676 FM 517 RD W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3904
Practice Address - Country:US
Practice Address - Phone:713-482-4535
Practice Address - Fax:713-482-4560
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08851363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant