Provider Demographics
NPI:1801245956
Name:BAKER, RYAN C (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:221 W. COLORADO BLVD
Mailing Address - Street 2:METHODIST PAVILION II, SUITE 443
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208
Mailing Address - Country:US
Mailing Address - Phone:214-271-9971
Mailing Address - Fax:214-271-9972
Practice Address - Street 1:221 W. COLORADO BLVD.
Practice Address - Street 2:METHODIST PAVILLION II, SUITE 940
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-271-9971
Practice Address - Fax:214-271-9972
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-09
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10058193390200000X
TXT1000208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty