Provider Demographics
NPI:1225144587
Name:RYAN, JAMES GREGORY (PSYD, LSSP, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GREGORY
Last Name:RYAN
Suffix:
Gender:M
Credentials:PSYD, LSSP, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24810 WATERSTONE ESTATES CIR W
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5544
Mailing Address - Country:US
Mailing Address - Phone:713-702-6076
Mailing Address - Fax:
Practice Address - Street 1:26205 OAK RIDGE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-1916
Practice Address - Country:US
Practice Address - Phone:832-534-3993
Practice Address - Fax:281-292-2365
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32280103TC0700X
TX1-12-10361103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst