MEDICARE: NANCY M RICKERHAUSER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	K1868	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8AQ215	OTHER	TX	BCBSTX
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245225135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY M RICKERHAUSER M.D.

Provider Business Mailing Address
First Line	:	815 FRONT ST
Second Line	:
City	:	COMFORT
State	:	TX
Zip	:	78013-2348
Country	:	US
Telephone Number	:	830-997-0330
Fax Number	:	830-997-7601

Provider Business Practice Location Address
First Line	:	815 FRONT ST
Second Line	:
City	:	COMFORT
State	:	TX
Zip	:	78013-0156
Country	:	US
Telephone Number	:	830-995-5633
Fax Number	:	830-997-7601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	04/09/2025

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