Individual ProviderZhanna RiddellFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1500 S Main St, Fort Worth, TX 76104-4917(817) 702-3431PECOS EnrollmentBased on the most recent information from CMS, provider Zhanna Riddell is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1194111484Provider TypeIndividualFull NameRiddell, ZhannaCredentialMDGenderFemaleSole ProprietorYesEnumeration Date4/13/2015Last Updated5/10/2024Contact InformationPractice LocationPractice Address1500 S Main St, Fort Worth, TX 76104-4917Phone(817) 702-3431FaxUnlisted FaxMailing LocationMailing Address1500 S Main St, Fort Worth, TX 76104-4917PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseR2791TexasCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer