Individual
DR. RYAN LEE PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(215) 662-2884
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
OS021125
PA
207RI0011X
Interventional Cardiology Physician
Primary
U3328
TX
Other
Enumeration date
05/03/2012
Last updated
05/12/2023
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