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General NPI Number Information
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NPI Number | 1215038583
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Entity Type | Individual
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Provider Name | DAVID A RIDDLESPURGER O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4150 SOUTHWEST DR SUITE 101
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City | ABILENE
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State | TX
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Zip | 79606-8222
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Country | US
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Telephone | 325-692-8396
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Fax | 325-698-3305
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Provider Business Mailing Address
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Address Line | 253 HARRISBURG RD
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City | ABILENE
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State | TX
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Zip | 79602-4349
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Country | US
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Telephone | 325-690-9537
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2065T
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License Number State | TX
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