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Organization
GUADALUPE FAMILY HEALTH, PA
Active
Organization
GUADALUPE FAMILY HEALTH, PA
Active
Other names
David M. Rider, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M RIDER M.D. (PRESIDENT)
(830) 379-7901
Entity
Organization
Contact information
Practice address
1414 E WALNUT ST, SEGUIN, TX 78155-5175
(830) 379-7901
Mailing address
PO BOX 1206, SEGUIN, TX 78156-1206
(830) 379-7901
(830) 401-0437
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076SK
BLUE CROSS BLUE SHIELD ID #
TX
05
—
2089765-01
—
TX
01
—
2089765-02
MEDICAID FOR TEXAS HEALTH STEPS
TX
Enumeration date
05/04/2009
Last updated
02/24/2015
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