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General NPI Number Information
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NPI Number | 1396245320
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Entity Type | Individual
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Provider Name | RYAN WOLFORD NP
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Gender | Male
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Dates
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Enumeration Date | 02/16/2018
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Last Update Date | 02/16/2018
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Provider Practice Location Address
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Address Line | 3591 MCKINNEY ST STE 400
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City | MELISSA
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State | TX
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Zip | 75454-9504
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Country | US
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Telephone | 972-464-1611
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Fax | 972-913-6216
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Provider Business Mailing Address
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Address Line | 2326 BRAZOS DR
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City | FRISCO
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State | TX
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Zip | 75033-1355
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Country | US
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Telephone | 214-803-8391
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP136604
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License Number State | TX
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