Organization
RYAN N.BOURNE,MD.PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN NOLAND BOURNE MD (PRESIDENT)
(210) 646-6556
Entity
Organization
Contact information
Practice address
8715 VILLAGE DR STE 400, SAN ANTONIO, TX 78217-5407
(210) 646-6656
(210) 646-6330
Mailing address
8715 VILLAGE DR, SUITE 400, SAN ANTONIO, TX 78217-5405
(210) 646-6556
(210) 646-6330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M9875
TX
207RC0000X
Cardiovascular Disease Physician
M9875
TX
207RI0011X
Interventional Cardiology Physician
Primary
M9875
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578730271
NPI INDIVIDUAL
TX
Enumeration date
09/10/2008
Last updated
02/06/2009
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