Provider Demographics
NPI:1366202947
Name:HUNTER, RYAN B (FMCHC)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:B
Last Name:HUNTER
Suffix:
Gender:M
Credentials:FMCHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8615 COLUMBIA FALLS DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-3429
Mailing Address - Country:US
Mailing Address - Phone:512-779-0773
Mailing Address - Fax:
Practice Address - Street 1:99 WALL ST # 2805
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-4301
Practice Address - Country:US
Practice Address - Phone:347-352-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171400000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach