Individual provider · NPI-1

Earl Warren Ryburn Jr., COTA

Rehabilitation Hospital · San Antonio, TX

NPI number1285025650
StatusActive
Last updated in NPPESFeb 6, 2015

Details

NPI
1285025650
Entity type
Individual (NPI-1)
Name
Mr. Earl Warren Ryburn Jr.
Credential
COTA
Sex
Male
Sole proprietor
Yes
Enumeration date
Feb 6, 2015
Last updated
Feb 6, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
283X00000X Rehabilitation Hospital208800TXYes
261QP2000X Clinic/Center, Physical Therapy208800TX
273Y00000X Rehabilitation Unit208800TX

Practice location

7555 Nw Loop 410
#114
San Antonio, TX 78245-2353

Phone 210-325-7330

Mailing address

14500 Blanco Rd
Apt 1324
San Antonio, TX 78216-7858

Phone 210-325-7330

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