1801019542 NPI number — DR. CHARLES COOK RICHTER JR. DDS

Table of content: AKIMI S MCKNIGHT CRNA (NPI 1013909084)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801019542 NPI number — DR. CHARLES COOK RICHTER JR. DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHTER
Provider First Name:
CHARLES
Provider Middle Name:
COOK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
DDS
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:
1801019542
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
405 N ST MARYS
Provider Second Line Business Mailing Address:
SUITE # 130
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78205-1747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-222-8260
Provider Business Mailing Address Fax Number:
210-222-2461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
405 N ST MARYS
Provider Second Line Business Practice Location Address:
SUITE # 130
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78205-1747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-222-8260
Provider Business Practice Location Address Fax Number:
210-222-2461
Provider Enumeration Date:
04/11/2007

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: 122300000X , with the licence number:  13019 , 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: K0057007 . This is a "DPS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com