Basic Information
| Provider Information | |||||||||
| NPI: | 1447242904 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DANIELSON | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1203 BOB WHITE DR | ||||||||
| Address2: | |||||||||
| City: | FRIENDSWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775465895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2819960505 | ||||||||
| FaxNumber: | 2814833392 | ||||||||
| Practice Location | |||||||||
| Address1: | NASA-JOHNSON SPACE CENTER SD32 AUDIOLOGY | ||||||||
| Address2: | 2101 NASA PARKWAY | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770583696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812446206 | ||||||||
| FaxNumber: | 2814833392 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2005 | ||||||||
| LastUpdateDate: | 10/11/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 51566 | TX | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.