Provider Demographics
NPI:1295704724
Name:BASS, RYAN NEIL (DC)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:NEIL
Last Name:BASS
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:611 N MACARTHUR BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7467
Mailing Address - Country:US
Mailing Address - Phone:972-253-9355
Mailing Address - Fax:972-253-9357
Practice Address - Street 1:331 N 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-6302
Practice Address - Country:US
Practice Address - Phone:972-253-9355
Practice Address - Fax:972-253-9357
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2021-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX10096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10096OtherSTATE DC LICENSE