Provider Demographics
NPI:1437130697
Name:SCHWALK, RYAN (PT)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:SCHWALK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2431 S LOOP 289
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1519
Mailing Address - Country:US
Mailing Address - Phone:806-771-8008
Mailing Address - Fax:806-771-8009
Practice Address - Street 1:2241 PEGGY LN STE C
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5709
Practice Address - Country:US
Practice Address - Phone:972-272-9643
Practice Address - Fax:972-272-9682
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPT1164443225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4728OtherBLUE CROSS BLUE SHIELD
TXP00804347OtherMEDICARE RAILROAD
TX149238100OtherFIRSTCARE
TX219757601Medicaid
TX219757602Medicaid
TX219757602Medicaid