Provider Demographics
NPI:1588751028
Name:PALMER, RICHARD LEE (AUD CCCA FAAA ABA)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:PALMER
Suffix:
Gender:M
Credentials:AUD CCCA FAAA ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S COULTER ST # A-105
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1710
Mailing Address - Country:US
Mailing Address - Phone:806-352-2321
Mailing Address - Fax:806-355-8941
Practice Address - Street 1:1600 S COULTER ST # A-105
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1710
Practice Address - Country:US
Practice Address - Phone:806-352-2321
Practice Address - Fax:806-355-8941
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51142231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C0217Medicare PIN