Provider Demographics
NPI:1447551130
Name:RISK, NAIF JOHN
Entity type:Individual
Prefix:MR
First Name:NAIF
Middle Name:JOHN
Last Name:RISK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 SOUTH CROCKET STREET
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5906
Mailing Address - Country:US
Mailing Address - Phone:903-892-2238
Mailing Address - Fax:903-868-0135
Practice Address - Street 1:102 SOUTH CROCKET STREET
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5906
Practice Address - Country:US
Practice Address - Phone:903-892-2238
Practice Address - Fax:903-868-0135
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-11
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies