Individual
RYAN WILLIAM GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
750 8TH AVE STE 200, FORT WORTH, TX 76104-2500
(682) 885-2170
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
T4925
TX
208000000X
Pediatrics Physician
T4925
TX
Other
Enumeration date
03/21/2018
Last updated
09/19/2022
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