Basic Information
Provider Information | |||||||||
NPI: | 1942437876 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | RICHTER | ||||||||
FirstName: | MAGGIE | ||||||||
MiddleName: | LE | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | LE | ||||||||
OtherFirstName: | MAGGIE MY | ||||||||
OtherMiddleName: | TIEU | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 6431 FANNIN ST | ||||||||
Address2: | MSB 3.286 | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770301501 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7135006412 | ||||||||
FaxNumber: | 7135007860 | ||||||||
Practice Location | |||||||||
Address1: | 929 GESSNER RD STE 1300 | ||||||||
Address2: |   | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770242469 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7134866600 | ||||||||
FaxNumber: | 7134867752 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/18/2009 | ||||||||
LastUpdateDate: | 10/27/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 10/27/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | BP1-0033833 | TX | N |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   | 207V00000X | P7490 | TX | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
ID Information
ID | Type | State | Issuer | Description | 330697901 | 05 | TX |   | MEDICAID |