Provider Demographics
NPI:1427210061
Name:FUSON, RYAN J (FNP-C, DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:J
Last Name:FUSON
Suffix:
Gender:M
Credentials:FNP-C, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E PRINCETON DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:TX
Mailing Address - Zip Code:75407-9008
Mailing Address - Country:US
Mailing Address - Phone:972-736-2259
Mailing Address - Fax:
Practice Address - Street 1:311 E PRINCETON DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407-9008
Practice Address - Country:US
Practice Address - Phone:972-736-2259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1048921363LF0000X
MDO3562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD486GMedicare PIN