| Organization Name: | RIDGEWOOD MEDICAL CLINIC |
| NPI Number: | 1659549004 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RHONDA GAIL GELBAR (PHYSICIAN ASSISTANT) |
| Mailing Address: | 219 W Kingsley Rd Ste 336 Garland |
| State: | TX US |
| Postal Code: | 750413434 |
| Phone Number: | 9722715544 |
| Fax Number: | 9722715567 |
| NPI Enumeration Date: | 02/19/2008 |
| NPI Last Update Date: | 02/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | PA00969 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |