1033212428 NPI number — RICHARD KARL SEARS MED LPC-S

Table of content: RICHARD KARL SEARS MED LPC-S (NPI 1033212428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033212428 NPI number — RICHARD KARL SEARS MED LPC-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEARS
Provider First Name:
RICHARD
Provider Middle Name:
KARL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MED LPC-S
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033212428
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 50392
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76206-0392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-753-2900
Provider Business Mailing Address Fax Number:
407-585-0099

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 BLACKBERRY WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76210-5274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-594-5234
Provider Business Practice Location Address Fax Number:
940-758-5009
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  10358 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 142636301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2984LC . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com