| Ridgewood Medical Clinic | |
|
219 W Kingsley Rd Suit 336 Garland TX 75041-3448 | |
| (972) 271-5544 | |
| Not Available |
| Full Name | Ridgewood Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 219 W Kingsley Rd, Garland, Texas |
| Authorized Official Name and Position | Bruce E. Wardlay (OWNER) |
| Authorized Official Contact | 9722715544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ridgewood Medical Clinic 219 W Kingsley Rd Suit 336 Garland TX 75041-3448 Ph: (972) 271-5544 | Ridgewood Medical Clinic 219 W Kingsley Rd Suit 336 Garland TX 75041-3448 Ph: (972) 271-5544 |
| NPI Number | 1497876288 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8426941899 |
|---|---|
| Medicare Enrollment ID | O20040209000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497876288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Robert L Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992929947 PECOS PAC ID: 2466345848 Enrollment ID: I20040209000148 |
| Provider Name | Bruce E Wardlay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881810794 PECOS PAC ID: 5698668077 Enrollment ID: I20040209000169 |
| Provider Name | Tuan A Trinh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033244553 PECOS PAC ID: 4284610494 Enrollment ID: I20040628001342 |
| Provider Name | Brian B Rogers |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1184828261 PECOS PAC ID: 7416089727 Enrollment ID: I20100722000573 |
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