Individual
MR. RYAN DANE TEICHELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7000 W 9TH AVE, AMARILLO, TX 79106-1709
(806) 350-2663
(806) 350-2664
Mailing address
P O BOX 52230, AMARILLO, TX 79159
(806) 350-2663
(806) 350-2664
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA05297
TX
363LF0000X
Family Nurse Practitioner
PA05297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8U9290
BCBS
TX
Enumeration date
08/27/2007
Last updated
09/26/2019
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