MEDICARE: RYAN K WALTER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	M3828	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144311507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN K WALTER MD

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-1924
Country	:	US
Telephone Number	:	254-215-9704
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 E 29TH ST
Second Line	:	SUITE 300
City	:	BRYAN
State	:	TX
Zip	:	77802-2531
Country	:	US
Telephone Number	:	979-776-0371
Fax Number	:	979-776-0495

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	06/23/2026

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Directions to “ RYAN K WALTER MD” Practice Location

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