Provider Demographics
NPI:1235372079
Name:COLLINS, RYAN JAMES (MPT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:COLLINS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 TOWN AND COUNTRY LN
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2226
Mailing Address - Country:US
Mailing Address - Phone:713-461-5050
Mailing Address - Fax:
Practice Address - Street 1:900 TOWN AND COUNTRY LN
Practice Address - Street 2:SUITE 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2226
Practice Address - Country:US
Practice Address - Phone:713-461-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1187313225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00636YMedicare PIN
TX8L13691Medicare UPIN