Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 37692 | TX |
Y | 103T00000X | Psychologist | 37692 | TX |
NPI | 1003468182 |
---|---|
Provider Name | Dr. Ryan Frank Pittsinger |
First Address | Bryan, TX 77803-3277 |
Second Address | Bryan, TX 77803-3277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2019 |
Last Update Date | 10/07/2019 |