Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | P3579 | TX |
N | 207Q00000X | Family Doctor | OS10717 | FL |
N | 207Q00000X | Family Doctor | P3579 | TX |
NPI | 1205065877 |
---|---|
Provider Name | Ryan Alan Seals |
First Address | Fort Worth, TX 76199-0335 |
Second Address | Fort Worth, TX 76107-2553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2009 |
Last Update Date | 26/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
301721201 | (05) | TX |
8DJ087 | BCBS (01) | TX |
P01560701 | RAILROAD MEDICARE (01) | TX |