Provider Demographics
NPI:1972613172
Name:STRICKLAND, RICHARD MARK (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARK
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 150569
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-6569
Mailing Address - Country:US
Mailing Address - Phone:817-888-8100
Mailing Address - Fax:817-677-0114
Practice Address - Street 1:14655 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7805
Practice Address - Country:US
Practice Address - Phone:817-888-8100
Practice Address - Fax:817-677-0114
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4573207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035882201Medicaid
TX035882202Medicaid
TX035882201Medicaid
TX035882202Medicaid
TX0027CDMedicare PIN
TXB26740Medicare UPIN