Provider Demographics
NPI:1285744128
Name:MCGEE, RYAN (PT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MCGEE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 CHASE LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3419
Mailing Address - Country:US
Mailing Address - Phone:954-873-1122
Mailing Address - Fax:
Practice Address - Street 1:701 TUSCAN DR
Practice Address - Street 2:SUITE 240
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-4133
Practice Address - Country:US
Practice Address - Phone:972-979-6577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX1250360225100000X
FLPT22502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT22502OtherLICENSE #