Provider Demographics
NPI:1104107747
Name:MALONE, RYAN PARENT (OD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:PARENT
Last Name:MALONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15337 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3832
Mailing Address - Country:US
Mailing Address - Phone:281-242-2020
Mailing Address - Fax:281-565-0888
Practice Address - Street 1:15337 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3832
Practice Address - Country:US
Practice Address - Phone:281-242-2020
Practice Address - Fax:281-565-0888
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7775T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist