Provider Demographics
NPI:1790983682
Name:JONES, RYAN FIEDLER (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:FIEDLER
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RYAN
Other - Middle Name:ELIZABETH
Other - Last Name:FIEDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6750 N MACARTHUR BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2484
Mailing Address - Country:US
Mailing Address - Phone:972-556-1616
Mailing Address - Fax:917-566-1740
Practice Address - Street 1:6750 N MACARTHUR BLVD STE 350
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-2484
Practice Address - Country:US
Practice Address - Phone:972-556-1616
Practice Address - Fax:917-566-1740
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4499207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214302602Medicaid
TX214302601Medicaid