MEDICARE: RYANN BARDWELL PHARMD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202217505	VA
2	183500000X	Pharmacist	57083	TX

General Provider Information

NPI Number	:	1700441607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYANN BARDWELL PHARMD.

Provider Business Mailing Address
First Line	:	935 CRESTMONT PLACE LOOP
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-1450
Country	:	US
Telephone Number	:	708-595-1002
Fax Number	:

Provider Business Practice Location Address
First Line	:	9029 HIGHWAY 6 STE 190
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4874
Country	:	US
Telephone Number	:	281-915-5055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2019
Last Update Date	:	05/06/2019

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Directions to “ RYANN BARDWELL PHARMD.” Practice Location

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