Individual
DR. JANE RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G1250
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128594207
—
TX
01
—
8K1648
BLUE CROSS
TX
Enumeration date
04/06/2006
Last updated
09/10/2012
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