Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | R8550 | TX |
NPI | 1013395433 |
---|---|
Provider Name | Matthew Ryan Danley |
First Address | Irving, TX 75038-2241 |
Second Address | Fort Worth, TX 76104-4111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2015 |
Last Update Date | 19/06/2020 |