Provider Demographics
NPI:1942973896
Name:RIDGE, DAVID (FNP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:RIDGE
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 WESTOVER HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-1967
Mailing Address - Country:US
Mailing Address - Phone:210-682-9434
Mailing Address - Fax:210-281-8904
Practice Address - Street 1:10010 WESTOVER HILLS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1967
Practice Address - Country:US
Practice Address - Phone:210-730-4957
Practice Address - Fax:210-281-8904
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1029818363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty