Provider Demographics
NPI:1154610707
Name:RICHARDS, CARTER MALONE (MD)
Entity type:Individual
Prefix:DR
First Name:CARTER
Middle Name:MALONE
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4114 POND HILL RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1272
Mailing Address - Country:US
Mailing Address - Phone:210-249-5020
Mailing Address - Fax:210-494-2209
Practice Address - Street 1:4114 POND HILL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1272
Practice Address - Country:US
Practice Address - Phone:210-249-5020
Practice Address - Fax:210-494-2209
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ81342084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program