Healthcare Provider Details

I. General information

NPI: 1972535169
Provider Name (Legal Business Name): ERIC R RITCHIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 10/11/2021
Certification Date: 10/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E BANDERA RD
BOERNE TX
78006-2802
US

IV. Provider business mailing address

110 E BANDERA RD
BOERNE TX
78006-2802
US

V. Phone/Fax

Practice location:
  • Phone: 210-481-1700
  • Fax:
Mailing address:
  • Phone: 210-481-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberL9872
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: