Individual
KEVIN RICKWARTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1501 S COULTER ST, AMARILLO, TX 79106-1770
(806) 354-1000
Mailing address
PO BOX 24691, FORT WORTH, TX 76124-1691
(817) 451-4208
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K9646
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037648501
—
TX
05
—
200033600A
—
OK
05
—
68773889
—
NM
01
—
81125S
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
10/18/2006
Last updated
05/02/2011
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