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NPI Code Detail

MEDICARE: RYAN UNG PHARMD

MEDICARE: RYAN UNG PHARMD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2183500000XPharmacist67007TX

General Provider Information

NPI Number : 1750886024
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN UNG PHARMD
Provider Business Mailing Address
First Line : 914 W 26TH ST APT 108
Second Line :
City : AUSTIN
State : TX
Zip : 78705-4351
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12601 TECH RIDGE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78753-3451
Country : US
Telephone Number : 512-491-6051
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2018
Last Update Date : 07/31/2020

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