Provider Demographics
NPI:1902470644
Name:MORALES, RYAN C
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:C
Last Name:MORALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-3517
Mailing Address - Country:US
Mailing Address - Phone:830-890-5300
Mailing Address - Fax:830-890-5308
Practice Address - Street 1:1216 BROADWAY
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-3517
Practice Address - Country:US
Practice Address - Phone:830-890-5300
Practice Address - Fax:830-890-5308
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251B00000XAgenciesCase Management