Provider Demographics
NPI:1225319452
Name:ARDOIN, RYAN LEE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:LEE
Last Name:ARDOIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130315
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77219-0315
Mailing Address - Country:US
Mailing Address - Phone:713-489-8182
Mailing Address - Fax:713-715-7166
Practice Address - Street 1:630 W 6TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-2422
Practice Address - Country:US
Practice Address - Phone:713-489-8182
Practice Address - Fax:281-715-7166
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1208632225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1208632OtherTX LICENSE