Provider Demographics
NPI:1992731715
Name:KEMP, RICHARD GALEN (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:GALEN
Last Name:KEMP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:R. GALEN
Other - Middle Name:
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1626 W 287 BUSINESS STE 105
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-4728
Mailing Address - Country:US
Mailing Address - Phone:972-937-0341
Mailing Address - Fax:972-923-0481
Practice Address - Street 1:1626 W 287 BUSINESS STE 105
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-4728
Practice Address - Country:US
Practice Address - Phone:972-937-0341
Practice Address - Fax:972-923-0481
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4154207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BV260OtherBCBS
TX100290905Medicaid
TX8F20444Medicare PIN