Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0101X | MOHS-Micrographic Surgeon | M6002 | TX |
Y | 207NS0135X | Procedural Dermatology | M6002 | TX |
NPI | 1003033838 |
---|---|
Provider Name | Ryan W Ahern |
First Address | College Station, TX 77845-8652 |
Second Address | College Station, TX 77845-8652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 30/01/2020 |