Healthcare Provider Details

I. General information

NPI: 1457277915
Provider Name (Legal Business Name): RYAN LOBATO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21128 SPRING TOWN DR
SPRING TX
77388-3509
US

IV. Provider business mailing address

314 MALTESE CIR
WYLIE TX
75098-0978
US

V. Phone/Fax

Practice location:
  • Phone: 888-227-8527
  • Fax:
Mailing address:
  • Phone: 832-784-0422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number793348
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: