RICHARD THOMAS ETHRIDGE MD (NPI# 1649438029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649438029 |
Entity Type | Organization |
Organization Name | RICHARD THOMAS ETHRIDGE MD |
Other Organization Name | ETHRIDGE PLASTIC SURGERY |
Practice Address |
1622 8th Ave Suite 130 Fort Worth TX 76104 |
Practice Telephone | 8179215566 |
Practice Fax Number | 8179215567 |
Enumeration Date | 2008-06-02 |
Last Update Date | 2019-02-27 |
Authorized Official Name | DR. RICHARD THOMAS ETHRIDGE (PHYSICIAN) |
Authorized Official Telephone | 8179215566 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
M5152 | TX | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Ethridge Plastic Surgery | Doing Business As Name - Organization |
Street Address |
1622 8TH AVE SUITE 130 |
City | FORT WORTH |
State | TX |
Zip Code | 76104 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700047511 | Laura Rae White | Physician Assistant | 1622 8th Ave, Suite 100, Fort Worth, TX 76104-4154 | 2008-06-24 |
1043341480 | Patrick Walsh Md Professional Association | Dermatology | 1622 8th Ave, 120, Fort Worth, TX 76104-4155 | 2007-03-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
Find all providers in zip 76104 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811037245 | Candis M Lovelace | Surgery | 4400 Heritage Trace Parkway, Suite 200, Fort Worth, TX 76244 | 2007-02-07 |
1134134406 | Emily B Mclaughlin | Surgery | 1200 W. Magnolia Ave, Suite 110, Fort Worth, TX 76104-4833 | 2006-07-29 |
1326064270 | Robert G Anderson | Surgery | 800 12th Ave Ste 100, Fort Worth, TX 76104-2519 | 2006-07-14 |
1013404904 | Steele Plastic Surgery Pllc | Surgery | 5656 Edwards Ranch Road, Suite 202, Fort Worth, TX 76109 | 2018-04-17 |
1417138157 | Shujaat A Khan M D P A | Surgery | 800 8th Ave, Ste 404, Fort Worth, TX 76104 | 2007-11-23 |
1376755819 | Patrick Chen, M.d.,p.a. | Surgery | 1325 Pennsylvania Ave, Ste 610, Fort Worth, TX 76104 | 2007-05-04 |
1740386515 | Shujaat A Khan | Surgery | 800 8th Ave, Ste 404, Fort Worth, TX 76104 | 2006-09-16 |
1306863998 | Raymond A Faires | Surgery | 1325 Pennsylvania Ave, Suite 325, Fort Worth, TX 76104-2175 | 2006-07-17 |
1407816408 | David M. Lavine | Surgery | 800 8th Ave, Suite 200, Fort Worth, TX 76104-2619 | 2006-03-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801408588 | Hill Country Plastic Surgery, Pllc | Surgery | 8042 Wurzbach Rd Ste 120, San Antonio, TX 78229-3818 | 2020-08-23 |
1154948198 | Walker Plastic Surgery Pllc | Surgery | 12590 Dallas Pkwy, Ste 200, Frisco, TX 75034 | 2020-06-25 |
1780242123 | Hands of Houston Pllc | Surgery | 6704 Ferris, Bellaire, Texas, TX 77401 | 2019-05-31 |
1609361419 | Texas Surgery Specialist, Pllc | Surgery | 1000 N Davis Dr Ste E, Arlington, TX 76012-3202 | 2018-06-25 |
1720575954 | Wijay Tops, Pllc | Surgery | 4306 Yoakum Blvd Ste 520, Houston, TX 77006-5883 | 2018-04-13 |
1437664067 | Austin Cosmetic Surgery | Surgery | 3102 Rr 620 S, Lakeway, TX 78734 | 2017-12-05 |
1326558594 | West Houston Aesthetic and Plastic Surgery Pllc | Surgery | 1717 Wisteria Way, Westlake, TX 76262-9083 | 2017-10-02 |
1235667189 | Lyos Plastic Surgery & Associates | Surgery | 9230 Katy Fwy Ste 420, Houston, TX 77055-7468 | 2017-05-23 |
1275071292 | Elite Breast & Trauma Care | Surgery | 7400 Fannin St # 700c, Houston, TX 77054-1920 | 2017-02-09 |
1699179390 | Sam T. Hamra M.d. P. A. | Surgery | 4131 N Central Expy # 950, Dallas, TX 75204-2102 | 2014-10-09 |
Find all providers with the same taxonomy |
City | FORT WORTH |
Zip Code | 76104 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.