Provider Demographics
NPI:1245233618
Name:RYLANDER, HENRY GRADY III (MD)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:GRADY
Last Name:RYLANDER
Suffix:III
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 1:3300 W ANDERSON LN
Mailing Address - Street 2:STE 308
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1023
Mailing Address - Country:US
Mailing Address - Phone:512-454-8744
Mailing Address - Fax:
Practice Address - Street 1:3300 W ANDERSON LN
Practice Address - Street 2:STE 308
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1023
Practice Address - Country:US
Practice Address - Phone:512-454-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2833207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX106197002Medicaid
TX106197002Medicaid
899003Medicare ID - Type Unspecified