Provider Demographics
NPI:1871576652
Name:RIGGINS, RICHARD RANDOLPH (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:RANDOLPH
Last Name:RIGGINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 COUNTY ROAD 139 N
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-7657
Mailing Address - Country:US
Mailing Address - Phone:409-489-0443
Mailing Address - Fax:866-382-1882
Practice Address - Street 1:162 COUNTY ROAD 139 N
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-7657
Practice Address - Country:US
Practice Address - Phone:409-489-0443
Practice Address - Fax:866-382-1882
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5195207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80722 KMedicare ID - Type Unspecified
TXF 53466Medicare UPIN