Provider Demographics
NPI:1124360045
Name:RA SURGICAL GROUP
Entity Type:Organization
Organization Name:RA SURGICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-213-4148
Mailing Address - Street 1:3290 BASTROP CT
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-4407
Mailing Address - Country:US
Mailing Address - Phone:214-213-4148
Mailing Address - Fax:214-269-3327
Practice Address - Street 1:3290 BASTROP CT
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-4407
Practice Address - Country:US
Practice Address - Phone:214-213-4148
Practice Address - Fax:214-269-3327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty