Basic Information
| Provider Information | |||||||||
| NPI: | 1396793162 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RITTGER | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 200993 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772160993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817841111 | ||||||||
| FaxNumber: | 2817841555 | ||||||||
| Practice Location | |||||||||
| Address1: | 6801 EMMETT F LOWRY EXPY | ||||||||
| Address2: | |||||||||
| City: | TEXAS CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775912500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4099385000 | ||||||||
| FaxNumber: | 4099385001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2006 | ||||||||
| LastUpdateDate: | 08/03/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | J7365 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8J9906 | 01 | TX | BCBSTX PROVIDER NO. | OTHER | P00285622 | 01 | TX | RAILROAD MEDICARE PROV NO | OTHER |