Provider Demographics
NPI:1740936046
Name:WENCL, RYAN PATRICK (APRN)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:WENCL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12031 SHOTGUN WAY
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4432
Mailing Address - Country:US
Mailing Address - Phone:817-994-2592
Mailing Address - Fax:
Practice Address - Street 1:10865 SHAENFIELD RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-9616
Practice Address - Country:US
Practice Address - Phone:210-698-7825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1071739363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care