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NPI Code Detail

MEDICARE: MR. RYAN MATTHEWS PTA

MEDICARE: MR. RYAN MATTHEWS PTA
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
1225200000XPhysical Therapy Assistant2170053TX

General Provider Information

NPI Number : 1871291781
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN MATTHEWS PTA
Provider Business Mailing Address
First Line : 6870 HEUERMANN RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78256-9605
Country : US
Telephone Number : 210-610-9097
Fax Number :
Provider Business Practice Location Address
First Line : 6870 HEUERMANN RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78256-9605
Country : US
Telephone Number : 210-610-9097
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2023
Last Update Date : 02/20/2023

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