Provider Demographics
NPI:1588540173
Name:RITTERHOUSE, KRYSTLE (RDCS, SRT, RVT)
Entity type:Individual
Prefix:
First Name:KRYSTLE
Middle Name:
Last Name:RITTERHOUSE
Suffix:
Gender:F
Credentials:RDCS, SRT, RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 SHANNON MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-5001
Mailing Address - Country:US
Mailing Address - Phone:405-434-6789
Mailing Address - Fax:
Practice Address - Street 1:923 SHANNON MEADOW TRL
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5001
Practice Address - Country:US
Practice Address - Phone:405-434-6789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2454762471C1106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C1106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiac-Interventional Technology