Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101264176 | VA |
N | 208600000X | Surgeon | 0101264176 | VA |
Y | 2086S0129X | Vascular Surgeon | 0101264176 | VA |
NPI | 1013259100 |
---|---|
Provider Name | Scott James Ryan |
First Address | Houston, TX 77030-1521 |
Second Address | Houston, TX 77030-1521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 30/03/2018 |