Individual
DR. ROBERT GLADSTONE RIDOUT III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2200 BERGQUIST DR STE 1, LACKLAND A F B, TX 78236-9908
(210) 292-5282
Mailing address
2200 BERGQUIST DR STE 1, LACKLAND A F B, TX 78236-9908
(210) 292-5282
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
E1250
TX
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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