Individual
NICHOLAS SCOTT RISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-1485
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1860
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101257601
VA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
R9846
TX
Other
Enumeration date
06/13/2012
Last updated
04/06/2021
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