Individual
RYAN CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1108 LAVACA ST STE 110-320, AUSTIN, TX 78701-2172
(512) 477-4088
(512) 482-0390
Mailing address
7620 DEER RUN, VOLENTE, TX 78641-6108
(512) 351-1035
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
AP125878
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343379602
—
TX
Enumeration date
08/06/2014
Last updated
12/23/2016
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