Provider Demographics
NPI:1679716658
Name:RATNAYAKE, KRISTIN JEAN (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:JEAN
Last Name:RATNAYAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:JEAN
Other - Last Name:TERICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1017 WAVERLY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2195
Mailing Address - Country:US
Mailing Address - Phone:760-613-4641
Mailing Address - Fax:
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113599207P00000X, 207PP0204X
TXV15952080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine