Provider Demographics
NPI:1124529144
Name:DRUMMER, RICHARD JOHN JR (PT)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOHN
Last Name:DRUMMER
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 MOUNTAINVIEW RD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-6804
Mailing Address - Country:US
Mailing Address - Phone:936-366-6798
Mailing Address - Fax:936-875-4977
Practice Address - Street 1:534 MOUNTAINVIEW RD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-6804
Practice Address - Country:US
Practice Address - Phone:936-366-6798
Practice Address - Fax:936-875-4977
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1150496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist