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NPI Code Detail

MEDICARE: MR. HENRY GRADY RYLANDER III M.D.

MEDICARE: MR. HENRY GRADY RYLANDER III M.D.
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
1207W00000XOphthalmology PhysicianE2833TX

Other Identifiers

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

General Provider Information

NPI Number : 1245233618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HENRY GRADY RYLANDER III M.D.
Provider Business Mailing Address
First Line : 3300 W ANDERSON LN
Second Line : STE 308
City : AUSTIN
State : TX
Zip : 78757-1023
Country : US
Telephone Number : 512-454-8744
Fax Number :
Provider Business Practice Location Address
First Line : 3300 W ANDERSON LN
Second Line : STE 308
City : AUSTIN
State : TX
Zip : 78757-1023
Country : US
Telephone Number : 512-454-8744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 03/10/2011

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