Provider Demographics
NPI:1508220948
Name:RYAN, DANA (OTR)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 PINEWOOD HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-5178
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13150 FM 529 RD
Practice Address - Street 2:SUITE 114
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-2570
Practice Address - Country:US
Practice Address - Phone:713-896-1815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117575225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist