Provider Demographics
NPI:1427091875
Name:RYDER, JAMES F (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:F
Last Name:RYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-593-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3938207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139344920Medicaid
TX139344908Medicaid
TX75-0818167-048OtherTRICARE
TX0043EJOtherBCBS
TX139344921Medicaid
TX75-2616977-028OtherTRICARE
TX884431OtherBCBS
TX139344919Medicaid
TX75-2616977-001OtherTRICARE
TX75-0818167-022OtherTRICARE
TX75-2616977-002OtherTRICARE
TX8EZ102OtherBCBS
TXP01478951OtherRAIL ROAD MEDICARE
TX75-2616977-002OtherTRICARE
TX8EZ102OtherBCBS
TX75-0818167-022OtherTRICARE
TX139344921Medicaid
TX884431OtherBCBS
TX406663YMAFMedicare PIN