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Individual

DR. RYAN MENZIES TIERNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4101 JAMES CASEY ST, SUTIE 100, AUSTIN, TX 78745-3325
(512) 447-2202
(512) 447-5337
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
BB4745785-2004014122
MO
2085R0001X
Radiation Oncology Physician
Primary
N3349
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
203872101
TX
05
203872102
TX
01
8CA670
BCBS
TX
01
P00784606
RAILROAD MEDICARE
TX
Enumeration date
10/04/2006
Last updated
02/19/2010
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