Provider Demographics
NPI:1295762961
Name:BURDEN, RYAN R (DC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:R
Last Name:BURDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 117502
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75011-7502
Mailing Address - Country:US
Mailing Address - Phone:214-668-3261
Mailing Address - Fax:
Practice Address - Street 1:2912 CROOKED CREEK DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5080
Practice Address - Country:US
Practice Address - Phone:214-668-3261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor