Individual
DR. DAVID M RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1414 EAST WALNUT, SEGUIN, TX 78155
(830) 379-7901
(830) 401-0737
Mailing address
PO BOX 1206, SEGUIN, TX 78156-1206
(830) 379-7901
(830) 401-0737
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0076SK
BLUE CROSS / BLUE SHIELD ID #
TX
05
—
2089773-01
—
TX
01
—
P00829322
MEDICARE RAILROAD PROVIDER PTAN
—
Enumeration date
07/10/2008
Last updated
08/05/2014
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