Provider Demographics
NPI:1205415544
Name:TERRY, RYAN L (CFST I, II)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:L
Last Name:TERRY
Suffix:
Gender:M
Credentials:CFST I, II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5358 TALLOWWOOD TER APT B
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-6001
Mailing Address - Country:US
Mailing Address - Phone:832-919-5150
Mailing Address - Fax:
Practice Address - Street 1:5358 TALLOWWOOD TER APT B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-6001
Practice Address - Country:US
Practice Address - Phone:832-919-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical