Provider Demographics
NPI:1518364710
Name:TIXIER, RYAN MOIR
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:MOIR
Last Name:TIXIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SHERMAN ST
Mailing Address - Street 2:APT 322
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2916
Mailing Address - Country:US
Mailing Address - Phone:626-623-9604
Mailing Address - Fax:
Practice Address - Street 1:901 SHERMAN ST
Practice Address - Street 2:APT 322
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2916
Practice Address - Country:US
Practice Address - Phone:626-623-9604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist