MEDICARE: RYAN HALL

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	363LF0000X	Family Nurse Practitioner	AP140138	TX

General Provider Information

NPI Number	:	1295293108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN HALL

Provider Business Mailing Address
First Line	:	1340 WONDER WORLD DR STE 2203
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-7791
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 WONDER WORLD DR STE 2203
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-7791
Country	:	US
Telephone Number	:	512-667-7123
Fax Number	:

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

Provider Enumeration Date	:	03/10/2019
Last Update Date	:	09/24/2024

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Directions to “ RYAN HALL ” Practice Location

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