Provider Demographics
NPI:1629284062
Name:CHRISTIAN, MAUREEN RYAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:RYAN
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 MECCA RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-1329
Mailing Address - Country:US
Mailing Address - Phone:512-294-3108
Mailing Address - Fax:
Practice Address - Street 1:3801 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7943
Practice Address - Country:US
Practice Address - Phone:512-443-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist