Individual
RYAN SCOTT REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 W. TERRELL AVE., FORT WORTH, TX 76104-3100
(817) 877-3277
(817) 877-3280
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 877-3280
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
N6607
TX
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
N6607
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
214299401
—
TX
01
—
P00850287
RAILROAD MEDICARE
TX
Enumeration date
06/21/2009
Last updated
09/30/2011
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