Organization Active NPI

Dru Riddle Anesthesia, PLLC

  • Ambulatory Surgical Clinic/Center
  • Fort Worth, TX
National Provider Identifier
1346751682
Registry record updated Oct 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
DRU RIDDLE ANESTHESIA, PLLC
Practice address
2800 W Bowie St
Fort Worth, TX 76109-1706
Phone
(817) 734-7980
NPI assigned
Oct 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jonathan Dru Riddle, PHD, DNP, CRNA
Title
Managing Partner
Phone
(817) 734-7980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

2800 W Bowie St
Fort Worth, TX 76109-1706

Mailing address

320 Silver Canyon Dr
Fort Worth, TX 76108-9612
Phone (817) 734-7980

National Provider Directory

National Provider Directory

Locations

2800 W Bowie St
Fort Worth, TX 76109
Phone (817) 734-7980

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507852800000",
    "number": "1346751682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SILVER CANYON DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761089612",
            "telephone_number": "817-734-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W BOWIE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761091706",
            "telephone_number": "817-734-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRU RIDDLE ANESTHESIA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-13",
        "last_updated": "2017-10-13",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DRU",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "817-734-7980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, DNP, CRNA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.