Provider Demographics
NPI:1336345065
Name:MAGUIRE, RYAN R (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:R
Last Name:MAGUIRE
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 1:101 S BALLARD AVE # B
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-3941
Mailing Address - Country:US
Mailing Address - Phone:972-429-4553
Mailing Address - Fax:972-429-4233
Practice Address - Street 1:101 S BALLARD AVE # B
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-3941
Practice Address - Country:US
Practice Address - Phone:972-429-4553
Practice Address - Fax:972-429-4233
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC8409111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B2888OtherBCBS