Richard Thomas Ethridge MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

M5152 Issued in TX

Legal business name

RICHARD THOMAS ETHRIDGE MD

Doing business as

Ethridge Plastic Surgery

Practice address

1622 8TH Ave
Suite 130
Fort Worth, TX 76104

Phone

(817) 921-5566

Fax

(817) 921-5567

NPI assigned

Jun 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Richard Thomas Ethridge, MD

Title

Physician

Phone

(817) 921-5566

Specialties & licenses 1

Addresses

Other names 1

• Ethridge Plastic Surgery Doing business as

Locations

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1649438029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 8TH AVE",
            "address_2": "SUITE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 8TH AVE",
            "address_2": "SUITE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76104",
            "telephone_number": "817-921-5566",
            "fax_number": "817-921-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD THOMAS ETHRIDGE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "ETHRIDGE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "817-921-5566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "M5152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ethridge Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ethridge Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robyn Rich
• Ryan Garcia Rich, PA-C
• Sonya Rich, LCSW
• Richard D Yentis MD Faacp PA (Richard Yentis MD)
• Richard T. Jones, PLLC
• Angelica Daniel Richard, LCSW
• Robert C Richard, DO
• Richards Laboratories of Texas
• Charnise Richards
• John A Richards, MD

• Plastic and Reconstructive Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; 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.