Provider Demographics
NPI:1124093323
Name:RIDGE PARTNERS,LLC
Entity type:Organization
Organization Name:RIDGE PARTNERS,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:INGEBRETSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-980-3777
Mailing Address - Street 1:32685 US HIGHWAY 281 N
Mailing Address - Street 2:SUITE 140
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-3271
Mailing Address - Country:US
Mailing Address - Phone:830-980-3777
Mailing Address - Fax:830-438-2560
Practice Address - Street 1:32685 US HIGHWAY 281 N
Practice Address - Street 2:SUITE 140
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-3271
Practice Address - Country:US
Practice Address - Phone:830-980-3777
Practice Address - Fax:830-438-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTX192Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER