Individual
MR. DAVID L RETTIG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
678659
TX
367500000X
Certified Registered Nurse Anesthetist
AP114534
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179460405
—
TX
01
—
8739UG
BCBS
TX
01
—
P01446010
RR
TX
Enumeration date
09/21/2006
Last updated
07/20/2023
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