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NPI Code Detail

MEDICARE: MR. ERIC CHARLES RITTER CRNA

MEDICARE: MR. ERIC CHARLES RITTER CRNA
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
1367500000XCertified Registered Nurse AnesthetistAP110866TX
2367500000XCertified Registered Nurse Anesthetist630933TX

General Provider Information

NPI Number : 1629046552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ERIC CHARLES RITTER CRNA
Provider Business Mailing Address
First Line : PO BOX 840853
Second Line :
City : DALLAS
State : TX
Zip : 75284-0802
Country : US
Telephone Number : 972-233-1999
Fax Number : 972-233-3666
Provider Business Practice Location Address
First Line : 3705 MEDICAL PKWY STE 570
Second Line :
City : AUSTIN
State : TX
Zip : 78705-1024
Country : US
Telephone Number : 512-454-2554
Fax Number : 512-454-2824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 09/01/2020

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