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Individual

RYAN PENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS LAT ATC

Contact information

Practice address
1702 ROBERT B CULLUM BOULEVARD, DALLAS, TX 75210-2319
(214) 775-8943
Mailing address
6106 SAINT MORITZ AVE, DALLAS, TX 75214-2319
(214) 493-9415

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5799
TX

Other

Enumeration date
10/27/2016
Last updated
10/27/2016
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