Provider Demographics
NPI:1629676150
Name:RYAN, CHRIS ADAM (ATP)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:ADAM
Last Name:RYAN
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 FM 1960 RD E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5229
Mailing Address - Country:US
Mailing Address - Phone:832-445-0956
Mailing Address - Fax:832-777-7023
Practice Address - Street 1:2111 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5229
Practice Address - Country:US
Practice Address - Phone:832-445-0956
Practice Address - Fax:832-777-7023
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment