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Organization
DRU RIDDLE ANESTHESIA, PLLC
Active
Organization
DRU RIDDLE ANESTHESIA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN DRU RIDDLE PHD, DNP, CRNA (MANAGING PARTNER)
(817) 734-7980
Entity
Organization
Contact information
Practice address
2800 W BOWIE ST, FORT WORTH, TX 76109-1706
(817) 734-7980
Mailing address
320 SILVER CANYON DR, FORT WORTH, TX 76108-9612
(817) 734-7980
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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