DR. ROBERT GLADSTONE RIDOUT III (NPI# 1144426826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144426826 |
Entity Type | Individual |
Full Name | DR. ROBERT GLADSTONE RIDOUT III |
Credential | M.D. |
Practice Address |
2200 Bergquist Dr Ste 1 Lackland A F B TX 78236-9908 |
Practice Telephone | 2102925282 |
Mailing Telephone | 2102925282 |
Enumeration Date | 2007-06-21 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 286500000X | Military Hospital | E1250 | TX | Hospitals |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710967146 | Robert M Ridout | Pathology | 5405 Plaza Dr, Texarkana, TX 75503-1662 | 2006-01-20 |
1407847239 | Robert Erick Ridout | Pediatrics | 1 Jarrett White Rd, Mchk-pe, Newborn Medicine Service, Tripler Amc, HI 96859-5001 | 2005-11-01 |
Street Address |
2200 BERGQUIST DR STE 1 |
City | LACKLAND A F B |
State | TX |
Zip Code | 78236-9908 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467891366 | Samantha Luanne Guy | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-06-24 |
1427492545 | Oscar Escano | General Practice | 2200 Bergquist Dr Ste 1, 59 Mhs/sgowv1, Lackland A F B, TX 78236-9908 | 2013-04-19 |
1881935112 | J T Floyd | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-03-12 |
1144583352 | Cleann Toner | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-06-21 |
1417223561 | Nancy Vogelgesang | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-03-22 |
1295011641 | Stephen Garrett Ray | Nurse Practitioner | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-10-31 |
1396029559 | Daniel Sung Oh | Military Health Care Provider | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-10-06 |
1184919763 | Marley Cranford Smith | Case Manager/Care Coordinator | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-06-13 |
1770881633 | Jennifer B Gillespie | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-03-02 |
1972804540 | Nilofer N Pervez Arthur | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Air Force Base, Lackland A F B, TX 78236-9908 | 2010-11-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
Find all providers in zip 78236 |
Taxonomy Code | 286500000X |
Grouping | Hospitals |
Classification | Military Hospital |
A health care facility operated by the Department of Defense. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578692638 | D'anna Linda-marie Sullivan | Military Hospital | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2007-03-05 |
1467507947 | Wilford Hall Medical Center | Military Hospital | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2007-01-24 |
1124198809 | Brooks City Base Clinic | Military Hospital | 2200 Bergquist Dr, Attn Credentials (cmc) Suite One, Lackland A F B, TX 78236-9907 | 2006-11-09 |
1760416614 | Wilford Hall Medical Center | Military Hospital | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2006-07-10 |
1912968595 | Wilford Hall Medical Center | Military Hospital | 2200 Bergquist Dr, Suite 1 Attn: Credentials Cmc, Lackland A F B, TX 78236-9907 | 2006-03-31 |
1861467193 | Wilford Hall Medical Center | Military Hospital | 2200 Bergquist Dr, Attn: Credentials (cmc), Lackland A F B, TX 78236-9907 | 2006-02-21 |
1366423741 | Us Army | Military Hospital | 2200 Bergquist Dr, Lackland A F B, TX 78236-9907 | 2005-11-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851773535 | Wbamc Dept of Medicine/im Training Program | Military Hospital | 5005 N. Piedras Street, Attn: Dom/im Program Wbamc, El Paso, TX 79920-5001 | 2015-06-18 |
1831578087 | Alma Denise Harman | Military Hospital | 13275 Emerald Creek Dr, Horizon City, TX 79928-6556 | 2015-05-20 |
1104216332 | Va Medical Center | Military Hospital | 10707 W Interstate 10 Apt 436, San Antonio, TX 78230-1674 | 2015-01-26 |
1366858938 | Baxter Healthcare Corporation | Military Hospital | 1618 Shady Holw, New Braunfels, TX 78132-2354 | 2014-07-03 |
1215353784 | Elizabeth Arnold | Military Hospital | 4539 Bissonnet St, Apt. 1, Bellaire, TX 77401-3127 | 2014-03-08 |
1770859878 | Oleg Balter | Military Hospital | 6231 Colony Crk, San Antonio, TX 78240-5320 | 2012-03-22 |
1255617676 | Department of Veterans Affairs | Military Hospital | 3022 Heritage Creek Oaks, Houston, TX 77008-6156 | 2011-10-31 |
1528357878 | Baylor College of Medicine | Military Hospital | 1709 Dryden Rd Ste 1100, Houston, TX 77030-2414 | 2011-04-06 |
1578898029 | Baylor College of Medicine | Military Hospital | 3103 Fairhope St, Houston, TX 77025-3228 | 2009-10-15 |
1548498058 | Yaoyao Zhu | Military Hospital | 1320 Austin Hwy, San Antonio, TX 78209 | 2009-06-24 |
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City | LACKLAND A F B |
Zip Code | 78236 |
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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.