Healthcare Provider Details

I. General information

NPI: 1891033627
Provider Name (Legal Business Name): RYAN R GADI RPH, MS, DPHARM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CIRCLE DR
HILLSBORO TX
76645-2670
US

IV. Provider business mailing address

PO BOX 251142
PLANO TX
75025-1142
US

V. Phone/Fax

Practice location:
  • Phone: 469-777-6010
  • Fax:
Mailing address:
  • Phone: 469-777-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number36001
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: