Provider Demographics
NPI:1942263199
Name:RYKER, CHAD R (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:R
Last Name:RYKER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:CHAD
Other - Middle Name:RANDALL
Other - Last Name:RAPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDD, MS
Mailing Address - Street 1:172 CREEKSIDE PARK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6221
Mailing Address - Country:US
Mailing Address - Phone:830-458-5174
Mailing Address - Fax:
Practice Address - Street 1:21477 STATE HIGHWAY 46 W STE 105
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6797
Practice Address - Country:US
Practice Address - Phone:830-438-5174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX368751223P0300X
OH30-02-1631122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics