Provider Demographics
NPI:1780688291
Name:DAVIES, RYAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:R
Last Name:DAVIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR,
Mailing Address - Street 2:MC B3.410
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-5000
Mailing Address - Fax:302-456-5015
Practice Address - Street 1:1935 MEDICAL DISTRICT DR # MCB3.410
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-5000
Practice Address - Fax:214-456-5015
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231289208600000X, 208G00000X
CAA110460208G00000X
DEC10009649208G00000X
TXR3497208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery