Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 31139 | SC |
N | 208000000X | Pediatrician | BP10023597 | TX |
Y | 2080P0202X | Pediatric Cardiologist | Q9585 | TX |
NPI | 1144491879 |
---|---|
Provider Name | Ryan James Butts |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2008 |
Last Update Date | 04/11/2016 |