Richard Lawrence Delezene, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05116 Issued in TX

Practice address

2010 E Villa Maria Rd Ste a
Bryan, TX 77802-2583

Phone

(979) 731-5200

Fax

(979) 821-7631

NPI assigned

Mar 30, 2007

Last updated

May 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1669723342
  NPD (past)
• Jonathan a. Friedman, M.D., PLLC

  • Physician Assistant
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  • NPI 1629127212
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1982724134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 E VILLA MARIA RD STE A",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022583",
            "telephone_number": "979-731-5200",
            "fax_number": "979-821-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 E VILLA MARIA RD STE A",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022583",
            "telephone_number": "979-731-5200",
            "fax_number": "979-821-7631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4421 Highway 6 S Ste 100",
            "address_purpose": "LOCATION",
            "city": "College Station",
            "state": "TX",
            "postal_code": "778456176",
            "country_code": "US",
            "telephone_number": "979-731-5200",
            "fax_number": "979-731-5210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELEZENE",
        "first_name": "RICHARD",
        "middle_name": "LAWRENCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "8385ND",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198917005",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vernita Dedrick
• James Otis Deegear IV, PH.D.
• Christopher Willis Defoy
• Zachary Aaron Degner, M.A.
• John Gerard Deleonibus Jr., PA-C
• Douglas Chiwai Deng
• Dental Care Associates, P.C.
• Dental Health Associates of Texas, PC (Dental Care of Bryan)
• Dentist in Bryan PLLC (Bryan Dental)
• Dentistry of Brownsville, PC (Topaz Dentistry)

• Physician Assistant in Bryan, TX
• Providers in Bryan, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.