Provider Demographics
NPI:1932232410
Name:RYAN, BILLY LLOYD (DC)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:LLOYD
Last Name:RYAN
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 1:458 PAMELA DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-1226
Mailing Address - Country:US
Mailing Address - Phone:210-533-0506
Mailing Address - Fax:210-533-1991
Practice Address - Street 1:458 PAMELA DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-1226
Practice Address - Country:US
Practice Address - Phone:210-533-0506
Practice Address - Fax:210-533-1991
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2512111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX600803Medicaid
TXDC2512OtherPROVIDER ID
TX741978834Medicare UPIN
TX600803Medicare ID - Type Unspecified