Basic Information
| Provider Information | |||||||||
| NPI: | 1851662142 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TONEY | ||||||||
| FirstName: | RYAN | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 E MOCKINGBIRD LN | ||||||||
| Address2: | #101 | ||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779042155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615136291 | ||||||||
| FaxNumber: | 3615762434 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 E MOCKINGBIRD LN | ||||||||
| Address2: | #101 | ||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779042155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615136291 | ||||||||
| FaxNumber: | 3615762434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2012 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | N8067 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 5101025909 | MI | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 299478201 | 05 | TX | MEDICAID | P01178677 | 01 | TX | RR MEDICARE | OTHER |