Provider Demographics
NPI:1033559778
Name:JONES, RYAN EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:EDWARD
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 HI LINE DR
Mailing Address - Street 2:#2209
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-3435
Mailing Address - Country:US
Mailing Address - Phone:469-337-4091
Mailing Address - Fax:
Practice Address - Street 1:1301 W 7TH ST
Practice Address - Street 2:STE 121
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-2651
Practice Address - Country:US
Practice Address - Phone:817-348-0425
Practice Address - Fax:817-348-0455
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4778207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine