Wade, Cody Ryan

Wade, Cody Ryan is an sole proprietor health care provider with primary practice located at 11850 Broadway St , Pearland TX 77584-3972. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer is his primary health care specialty. Wade, Cody Ryan can be contacted via phone (281) 299-2127.

Contact Information

Primary practice address
11850 Broadway St Pearland TX 77584-3972
Phone: (281) 299-2127
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 070802059 Texas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT4303 Texas

Profile Details

NPI number 1740731785
LBN Legal business name Wade, Cody Ryan
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 14th, 2016
Last updated Jan 5th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740731785 NPPES
Texas Other 22 ATHLETIC TRAINER

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