Provider Demographics
NPI:1639563240
Name:RIGEL GERIATRICS PLLC
Entity Type:Organization
Organization Name:RIGEL GERIATRICS PLLC
Other - Org Name:TEXAS GERIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RANJITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMPALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-693-8164
Mailing Address - Street 1:18823 ROGERS PASS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4621
Mailing Address - Country:US
Mailing Address - Phone:210-493-7995
Mailing Address - Fax:
Practice Address - Street 1:1580 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3312
Practice Address - Country:US
Practice Address - Phone:830-443-9958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211019901Medicaid
TXTXB120995Medicare PIN