Healthcare Provider Details

I. General information

NPI: 1013827716
Provider Name (Legal Business Name): RYAN CALLAHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15201 RONALD W REAGAN BLVD STE 212
LEANDER TX
78641-1237
US

IV. Provider business mailing address

15201 RONALD W REAGAN BLVD STE 212
LEANDER TX
78641-1237
US

V. Phone/Fax

Practice location:
  • Phone: 888-611-9114
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number856794
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: