Provider Demographics
NPI:1457915365
Name:TOMAS, RYAN R
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:R
Last Name:TOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 ARVILLE ST APT 272
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2761
Mailing Address - Country:US
Mailing Address - Phone:725-256-5771
Mailing Address - Fax:
Practice Address - Street 1:3750 ARVILLE ST APT 272
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2761
Practice Address - Country:US
Practice Address - Phone:725-256-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178010953101YP2500X
NVCP1284R101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional