Healthcare Provider Details

I. General information

NPI: 1174712228
Provider Name (Legal Business Name): RYAN O'QUINN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9238 FLOYD CURL DR SUITE 101
SAN ANTONIO TX
78240-1690
US

IV. Provider business mailing address

PO BOX 2317
SAN ANTONIO TX
78298-2317
US

V. Phone/Fax

Practice location:
  • Phone: 210-558-6234
  • Fax: 210-615-1840
Mailing address:
  • Phone: 210-558-6288
  • Fax: 210-558-6289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RYAN PATRICK O'QUINN
Title or Position: PRESIDENT
Credential: MD
Phone: 210-558-6234