Provider Demographics
NPI:1720562085
Name:BALL, RILEY PATRICK (RN)
Entity Type:Individual
Prefix:MR
First Name:RILEY
Middle Name:PATRICK
Last Name:BALL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 W 21ST ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3512
Mailing Address - Country:US
Mailing Address - Phone:713-385-2657
Mailing Address - Fax:
Practice Address - Street 1:724 W 21ST ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3512
Practice Address - Country:US
Practice Address - Phone:713-385-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX947229163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse