Provider Demographics
NPI:1881191617
Name:RIDDLE, BARRETT CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:CHARLES
Last Name:RIDDLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2190 NORTH LOOP W STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8016
Mailing Address - Country:US
Mailing Address - Phone:281-810-1792
Mailing Address - Fax:
Practice Address - Street 1:2190 NORTH LOOP W STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8016
Practice Address - Country:US
Practice Address - Phone:281-810-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20230027912085R0202X
TXT36892085R0202X, 2085R0202X
TXBP200684562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology