MEDICARE: RYAN DAVID KLEMENT PT

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	208100000X	Physical Medicine & Rehabilitation Physician	1088979	TX
2	225100000X	Physical Therapist	1088979	TX

General Provider Information

NPI Number	:	1790710713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN DAVID KLEMENT PT

Provider Business Mailing Address
First Line	:	2114 TEXOMA PKWY
Second Line	:	650
City	:	SHERMAN
State	:	TX
Zip	:	75090-2683
Country	:	US
Telephone Number	:	903-813-1551
Fax Number	:	903-813-1725

Provider Business Practice Location Address
First Line	:	2114 TEXOMA PKWY
Second Line	:	650
City	:	SHERMAN
State	:	TX
Zip	:	75090-2683
Country	:	US
Telephone Number	:	903-813-1551
Fax Number	:	903-813-1725

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	09/29/2015

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Directions to “ RYAN DAVID KLEMENT PT” Practice Location

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