Provider Demographics
NPI:1841282365
Name:RITTER, DAVID W (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:RITTER
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 127
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-0127
Mailing Address - Country:US
Mailing Address - Phone:972-412-7700
Mailing Address - Fax:972-412-7710
Practice Address - Street 1:6705 HERITAGE PKWY STE 104
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-8729
Practice Address - Country:US
Practice Address - Phone:972-412-7700
Practice Address - Fax:972-412-7710
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4481174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020041051OtherMEDICARE RR
TX5880610001OtherCIGNA
TX78161OtherAMERIGROUP
TX752757262OtherTAX ID
TX2159803OtherAETNA HMO
TX1822273OtherUNITED HEALTHCARE
TX0309551-01Medicaid
TX5768505OtherAETNA
TX8G0301OtherBC/BS
TX5768505OtherAETNA