Ryan N.Bourne,MD.PA

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

M9875 Issued in TX

Legal business name

RYAN N.BOURNE,MD.PA

Practice address

8715 Village Dr Ste 400
San Antonio, TX 78217-5407

Phone

(210) 646-6656

Fax

(210) 646-6330

NPI assigned

Sep 10, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ryan Noland Bourne, MD

Title

President

Phone

(210) 646-6556

Specialties & licenses 3

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1841449253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8715 VILLAGE DR",
            "address_2": "SUITE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175405",
            "telephone_number": "210-646-6556",
            "fax_number": "210-646-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8715 VILLAGE DR STE 400",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175407",
            "telephone_number": "210-646-6656",
            "fax_number": "210-646-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN N.BOURNE,MD.PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "BOURNE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "NOLAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-646-6556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M9875",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "M9875",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "M9875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI  INDIVIDUAL",
            "identifier": "1578730271",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Interventional Cardiology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Interventional Cardiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.