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General NPI Number Information
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NPI Number | 1740134493
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Entity Type | Individual
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Provider Name | RYAN SHOWALTER
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Gender | Male
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 340 E 1ST AVE
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City | BROOMFIELD
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State | CO
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Zip | 80020-2401
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Country | US
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Telephone | 303-466-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 3313 AUSTIN CT
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City | HURST
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State | TX
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Zip | 76054-6043
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Country | US
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Telephone | 817-964-2211
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1407952
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License Number State | TX
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