Provider Demographics
NPI:1801496260
Name:RICHARDSON, LAURA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 KELLER SPRINGS RD APT 1170
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-6389
Mailing Address - Country:US
Mailing Address - Phone:469-569-0368
Mailing Address - Fax:
Practice Address - Street 1:2305 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3800
Practice Address - Country:US
Practice Address - Phone:214-953-0165
Practice Address - Fax:214-953-0156
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist