Provider Demographics
NPI:1992798045
Name:RITCHIE, BETTY R (PAC)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:R
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9955 DYER ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-4709
Mailing Address - Country:US
Mailing Address - Phone:915-751-1249
Mailing Address - Fax:915-757-9454
Practice Address - Street 1:9955 DYER ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4709
Practice Address - Country:US
Practice Address - Phone:915-751-1249
Practice Address - Fax:915-757-9454
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00351363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant