Healthcare Provider Details

I. General information

NPI: 1275501652
Provider Name (Legal Business Name): RYAN MCFARLAND OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15101 EAST FWY
CHANNELVIEW TX
77530-4104
US

IV. Provider business mailing address

2928 LINDA DR
PEARLAND TX
77584-1307
US

V. Phone/Fax

Practice location:
  • Phone: 832-200-5514
  • Fax: 832-200-1030
Mailing address:
  • Phone: 281-782-7745
  • Fax: 281-997-3552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number109993
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: