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General NPI Number Information
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NPI Number | 1679330724
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Entity Type | Individual
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Provider Name | ADAMSON RYAN WRIGHT PTA
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Gender | Male
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 2171 WOODWARD ST
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City | AUSTIN
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State | TX
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Zip | 78744-1049
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Country | US
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Telephone | 512-610-3001
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Fax |
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Provider Business Mailing Address
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Address Line | 9308 S 1ST ST APT 1513
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City | AUSTIN
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State | TX
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Zip | 78748-0017
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Country | US
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Telephone | 248-303-0584
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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 | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 2181063
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License Number State | TX
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