Individual
BLYTHE RIDDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14205 N MO PAC EXPY STE 570, AUSTIN, TX 78728-6529
(512) 217-3799
(469) 312-2506
Mailing address
14205 N MO PAC EXPY STE 570, AUSTIN, TX 78728-6529
(469) 312-2506
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
18440
TX
Other
Enumeration date
10/28/2024
Last updated
06/30/2025
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